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the distribution of low-quality tourniquets that could be deadly. 6. Bulger EM, Snyder D, Schoelles K, et al. An evidence-based pre-
It is important to ensure that only high-quality tourniquets are hospital guideline for external hemorrhage control: American
donated to soldiers who are on the frontline. Donating poor College of Surgeons Committee on Trauma. Prehosp Emerg Care.
2014;18(2):163–173.
quality tourniquets can have serious consequences and must be 7. Drew B, Montgomery HR, Butler FK. Tactical Combat Casualty
avoided. We therefore strongly support using well-established Care (TCCC) guidelines for medical personnel: 05 November
and approved tourniquets. 2020. J Spec Oper Med Peer Rev J SOF Med Prof. 2020;20(4):
144–151.
8. Tech Against Tanks. https://techagainsttanks.com/en/modele/
Conclusion tourniquet/. Accessed 16 October 2023.
We found that our sample of 3D-printed tourniquets—cur- 9. Polston RW, Clumpner BR, Kragh JF, et al. No slackers in tourni-
rently used in the war in Ukraine—could maintain pressure quet use to stop bleeding. J Spec Oper Med Peer Rev J SOF Med
Prof. 2013;13(2):12–19.
as well as the commercially available tourniquets. Indeed, our 10. Wall PL, Duevel DC, Hassan MB, et al. Tourniquets and occlu-
tests results demonstrated that they could maintain a signifi- sion: the pressure of design. Mil Med. 2013;178(5):578–587.
cantly higher pressure. 11. Montgomery HR, Hammesfahr R, Fisher AD, et al. 2019 recom-
mended limb tourniquets in tactical combat casualty care. J Spec
Acknowledgments Oper Med. 2019;19(4):27–50.
The authors extend their sincere respect to the people of 12. European Commision. The ‘Blue Guide’ on the implementation of
EU product rules 2022. Published online June 29, 2022. https://single-
Ukraine. market-economy.ec.europa.eu/news/blue-guide-implementation
-product-rules-2022-published-2022-06-29_en Accessed 16 Octo-
Author Contributions ber 2023.
Conceptualization: JM, NC, PBS; Investigation: JM, NC; Writ- 13. Grebing BR, Coughlin MJ. Evaluation of the Esmark Bandage
ing: JM; Review and editing: PBS, NC, MR, EBR; Statistics as a tourniquet for forefoot surgery. Foot Ankle Int. 2004;25(6):
and visualization: JM; Supervision: EBR. 397–405.
14. Reback J, jbrockmendel, McKinney W, et al. pandas-dev/pandas:
Pandas 1.3.4. Published online October 17, 2021. https://zenodo.
Disclosures org/records/3630805 Accessed 16 October 2023.
The authors declare no conflict of interest. 15. Vallat R. Pingouin: statistics in Python. J Open Source Softw.
2018;3(31):1026.
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