The Journal of surgical research
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The pathophysiology of skeletal muscle injury induced by compression beneath pneumatic tourniquets is poorly understood. Tourniquet hemostasis was induced in rabbit hindlimbs for 2 hr with a cuff inflation pressure of either 125 mm Hg (n = 5) or 350 mm Hg (n = 5). Skeletal muscle biopsies, taken 2 days later from tissue beneath and distal to the tourniquet, were frozen and analyzed using enzyme- and immunohistochemical techniques. ⋯ Extremely large and rounded fibers (histochemically identified as Type IIB fibers) were observed in compressed thigh muscles, indicating differential fiber sensitivity to tourniquet compression and ischemia. The present study demonstrated significant skeletal muscle necrosis after a 2 hr tourniquet applied at a clinically relevant cuff inflation pressure. Recent studies of systemic changes associated with limb "ischemia" should be reassessed in consideration of the confounding effects of tissue compression induced beneath pneumatic tourniquets.