Experimental Assessment of Tourniquet Times Effect on Course and Outcome of Combined Radiation and Mechanical Injury

BACKGROUND: Acute uncompensated blood loss due to continuous external bleeding is a common cause of death among military personnel wounded in combat. Tourniquets have been recognized as the primary method to temporarily control bleeding. Successful injury management is predicated on the adherence to recommended guidelines for tourniquet application and replacement with blood flow restoration. For combined radiation injury, shorter tourniquet times are associated with extended radiation component.

AIM: This study aimed to establish the correlation between hemostatic tourniquet times and the course and outcome of moderate combined radiation and mechanical injuries in an experimental setting.

METHODS: The study included 60 male Soviet Chinchilla rabbits with an average body weight of 2.5–3 kg. The animals were exposed to a single dose (6 Gy) of uniform γ-radiation and had mechanical damage to tissues and a large artery of the limb with hemoexfusion of 30% of the circulating blood volume. The tourniquet time was 15, 45, or 120 minutes. A The mechanical component of the injury was initiated 1 hour post-exposure.

RESULTS: In the combined radiation and mechanical injury model, prolonged tourniquet time was associated with a more adverse outcome. Specifically, 8 (80%) rabbits survived after a 15-minute tourniquet application, with 30% survival (3 rabbits) observed at 45 minutes and 20% (2 rabbits) at 120 minutes. Tourniquet time did not affect the onset of radiation component of the injury. Comparison of the groups with the reproduced model of the combined injury and isolated injury showed that the radiation component did not affect the survival of animals with combined radiation and mechanical injuries.

CONCLUSION: Prolonging tourniquet time is crucial in increasing animal mortality, with this effect being independent of the radiation component (in the specified experimental model). If we extrapolate the experimental data to humans, it can be concluded that individuals with combined radiation injury and those who suffer from isolated injury should be medically evacuated in a way that minimizes tourniquet time. Furthermore, it is critical to consider medical and tactical situations to ensure that the most effective methods for bleeding control are used.