**3.5. Complication related to wound healing**

Wound condition after TKA is important for the prevention of periprosthetic infection [50, 51]. Delay in wound healing is associated with deep infection, which leads to the arthroplasty failure [52].

The use of a tourniquet is associated with a higher incidence of postoperative wound problems [3, 5, 28, 44], including significant hematoma, wound oozing, skin blistering, bruising, necrosis, and superficial wound infection requiring antibiotics treatment. Circulatory stasis caused by tourniquet inflation may worsen the local soft tissue condition [5]; furthermore, reactive hyperemia and activation of fibrinolytic cascade after tourniquet release increase the tissue pressure and local inflammation [3, 53], all of which lead to tissue hypoxia and subsequently compromised wound healing.
