Clean up varicose vein surgery--use a tourniquet.

A controlled randomised trial has been carried out to ascertain if there are tangible benefits from using a tourniquet when avulsing varicose veins during routine varicose vein surgery. Twenty-six patients have been studied. Twenty limbs were operated on with a tourniquet and 20 limbs without a tourniquet. The mean weight of varices excised was 2.76 g (range 0.51-8.79 g) with a tourniquet and 2.68 g (0.77-11.27 g) without a tourniquet (NS, Wilcoxon's rank sum test). Mean blood loss was 16 ml (0-136 ml) with a tourniquet and 107 ml (16-581 ml) without a tourniquet (P less than 0.01, Wilcoxon's rank sum test). The mean time to complete avulsions was 38 min with a tourniquet and 35 min without a tourniquet (NS, Student's t test). The tangible benefits of a tourniquet are limited to the saving of blood which can amount to 500 ml per leg. Losses could amount to 1 litre in bilateral cases operated upon without tourniquet. The method is simple, provides a clean operating field and should be more widely used.