In knee arthroplasty, deflating the tourniquet before wound closure helps with intraoperative visibility and postoperative pain; deflate prior to wound closure to assess hemostasis and tissue perfusion and reduce postoperative pain. What is the primary reason for deflating the tourniquet before closure?

• A. Increase intraoperative visibility
• B. Shorten operative time
• C. Improve hemostasis and tissue perfusion while reducing postoperative pain
• D. Reduce risk of infection

Answer: (C)

The main idea is to verify that bleeding is controlled and tissue is adequately perfused before closing the wound. When the tourniquet is released, you can see any oozing that was masked by the ischemic, bloodless field and address it immediately, achieving true hemostasis. Reperfusion also lets you assess limb perfusion by observing color, warmth, and distal signals, confirming there isn’t hidden ischemia or perfusion problems. Doing this before closure helps prevent postoperative complications from unaddressed bleeding or poor tissue viability and can reduce pain related to ischemia-reperfusion. While a bloodless field can aid visibility and reduced pain can accompany reperfusion, the primary reason for deflating before closure is to ensure hemostasis and tissue perfusion are satisfactory.