Compartment syndrome and fasciotomy in vascular surgery. A review of 57 cases

Department of Vascular Surgery, Aalborg Hospital, Denmark.
European Journal of Vascular and Endovascular Surgery (Impact Factor: 2.49). 02/1997; 13(1):48-53. DOI: 10.1016/S1078-5884(97)80050-0
Source: PubMed


To investigate the occurrence of compartment syndrome and the results of fasciotomy in vascular surgical patients.
Retrospective study of case records from 1980-1994.
Fifty-seven limbs in 53 patients had fasciotomies following surgical revascularisation. Fifty-three (93%) limbs were acutely ischaemic, while four (7%) had undergone elective vascular surgery. Forty-four (77%) limbs had signs of compartment syndrome, while 13 (23%) fasciotomies were prophylactic.
The fasciotomies were done as subcutaneous procedures (n = 40), as double-incision fasciotomies (n = 11), or by an unknown method (n = 6). The skin incisions were closed primarily in 26 (46%) cases, delayed primarily in 11 (19%) cases, and by skin grafting in eight cases (14%).
Five (13%) subcutaneous fasciotomies required revision. Surgical debridement was required in four (7%) limbs. At discharge, 36 (68%) patients had kept their limbs, 11 (21%) patients were amputated, and six (11%) had died. No complications relating to the fasciotomies were observed.
Compartment syndrome is usually related to acute ischaemia and rarely following elective vascular surgery. Subcutaneous fasciotomy does not always ensure sufficient decompression of all four lower leg compartments. Complications related to fasciotomy are rare.

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    • "Subcutaneous fasciotomy does not always ensure sufficient decompression of all four lower leg compartments (12). Complications related to fasciotomy are rare (12). When revascularization is made after six hours, the prophylactic fasciotomy is recommended (13). "
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    ABSTRACT: Vascular injury represents less than 1% of all injuries, but deserves special attention because of its severe complications. Amputation or retention of a painful functionless limb is the most untoward result of severe vascular injury or inadequate treatmet. Thus, vascular injury needs a judicious and multidimensional approach. This retrospective study was done to asess the outcome of minor modifications of the methodology of extremity fasciotomy by making it liberal with respect to incision and definition. Out of 55 patients in 2008, 45 patients (Group A) had either no fasciotomy or limited primary fasciotomy, 10 patients (Group B) had primary liberal fasciotomy. Another group from 2008 onwards had undergone primary liberal fasciotomy in all the 45 patients (Group C). In group A, we had 5 amputations and one death. In group B, there were no amputations or deaths and from group C, we had one amputation and no deaths. Blunt and distal traumatic vascular injury of the extremities and its repair should always combined with primary liberal fasciotomy, which although increases manageable morbidity, avoids disability (functional as well as anatomical).
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    ABSTRACT: Objective: We aimed to compare the postoperative complications in patient with acute lower extremity arterial occlusion who admitted in the late period in whom accompanying embolectomy and fasciotomy in the same session and fasciotomy following embolectomy were applied, because of development of compartment syndrome. Methods: A total of 36 patients (13 female, 23 male) with acute lower extremity arterial occlusion, who admitted to our clinic at least 12 hours after onset of symptoms were enrolled to the study and investigated retrospectively. While embolectomy was performed in all cases, the cases in which mini fasciotomy was performed after development of compartment syndrome constitute the group 1 (n=21) and the ones in whom accompanying embolectomy and closed mini fasciotomy in the same session constitute the group 2 (n=15), groups were formed randomly. Groups were compared in regard of extremity amputation, renal failure, hypoesthesia in lower extremity, paresthesia in fingers in their clinical course. In statistical analysis t test, Chi-square test and Mann Whitney U test were used for comparison of groups, and a p
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    ABSTRACT: Acute compartment syndrome of the lower extremity is a limb-threatening emergency that requires prompt surgical treatment. Early detection and decompression are necessary in order to avoid irreversible damage. In the lower extremity, compartment syndrome may occur around the pelvis, in the thigh, the lower leg or the foot. Acute compartment syndrome of the lower leg is most common. Sometimes, combined compartment syndromes of neighbouring skeletal regions are observed. In this review, the specific clinical symptoms as well as the anatomic and therapeutic characteristics of the acute compartment syndrome of the lower extremity are described.
    European Journal of Trauma and Emergency Surgery 02/1982; 33(6):589-599. DOI:10.1007/s00068-007-7161-y · 0.35 Impact Factor
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