Frag Out! Magazine

G e n e S i S The constricting bands are known almost as long as human kind takes part in combats – the first documented applications occurred during wars led by Alexander the Great, certainly in order to stanch bleedings and hemorrhages (however, with different effect). Later the Romans began to use them also during amputations. They were made from bronze with leather elements and until 18th century they were used in a limited range. From the army they were brought to the civil life where were used mainly as the safeguards during the limb am- putations. All this time constricting bands were, of course, used, but these were the bands which resemble very much used nowadays improvised tourniquets/constricting bands (in the form of the garrote – e.g. a piece of fabric and a stick). It was only during the campaigns of Napoleon Bon- aparte, a French physician Jean Louis Petit developed a device – a tourniquet – in which by rotating a switch, a tightening element was constricted, occluding both venous and arte- rial flow. A device invented by Louis Petit had been applied successfully until 20th century when it was complemented by a rubber band- age developed by Frederich von Esmarch who implemented it successfully to control arterial hemorrhages (not only venous ones). Unfortu- nately, researches done by Richard von Volk- mann confirmed single cases of ischemic limb paralysis when using this device. In 20th century Harvey Cushing created a constricting band in the form of the pumped sleeve which besides that could be applied and removed equally quickly, substantial- ly decreased frequency of occurring cases of the nerve paralysis when compared with the Esmarch's bandage. The application of the constricting bands in protect- ing hemorrhages was its basic usage until applying them, a few years later after the Cushing's discov- ery, for a segmental analgesia (anesthesia). August Bier used two tourniquets to provide a blood-free intervention in the field between them (this method is It is also commonly referred to as Bier block, or Bier's method) – later modernizations of this meth- od was introduced by Hamilton E. Holmes. At the end of the 20th century, there was launched an avalanche of ideas linked to the application of the constricting bands in medicine. Unfortunate- ly, considering still remembered researches of von Volkmann, in the army still were left a model resembling rather a tourniquet for blood drawing than constricting bands. In the Polish army there were used the constricting bands on the basis of the piece of the fabric and a rod although usually they lied in the storehouses. The Americans used in this time wide rubber and fabric straps with a buckle which, in fact, did not work and – as mentioned one of the veterans of the Vietnam War – they were commonly applied as a perfect … suitcase fastener. www.fragoutmag.com

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