AN INVESTIGATION INTO THE EFFECT OF ISCHEMIA AND PRESSURE ON IRRITANTINFLAMMATION

Reports of chemical burns beneath tourniquets during orthopaedic proce dures led us to explore the irritant effects produced by the skin anti septics used during such procedures. A sphygmomanometer and tourniquet , at a pressure of 200 mmHg for 30 min, was used to create pressure an d ischaemia which were then examined separately for their respective e ffects on irritant inflammation in normal subjects and those with atop ic eczema. As no inflammation could be demonstrated with the antisepti cs, we subsequently used the known irritant chemical anthralin to exam ine the effect of ischaemia with and without pressure. Site-related va riation in anthralin-induced inflammation was observed but there was n o demonstrable effect of either pressure or ischaemia on the inflammat ory response. Therefore, as we are unable to show a relationship betwe en ischaemia with or without pressure and irritant inflammation, we co nclude that burns under tourniquets are likely to be idiosyncratic rea ctions and their further investigation requires examination of the ind ividuals affected.