A Unique Treatment for Compartment Syndrome After Intravenous Catheter Extravasation: A Case Report

Abstract

Intravenous cannulation is performed on nearly every patient presenting for an anesthetic. Complications of the procedure include infiltration and extravasation, which can have a varied impact on the patient. Here, we present a case of severe intravenous (IV) extravasation, resulting in compartment syndrome of the hand. Rather than treating the compartment syndrome with fasciotomies as is standard, we utilized compression therapy via an Esmarch surgical dressing wrapped distal to proximal on the effected limb, which resulted in marked decrease in swelling and return of perfusion to the hand.

Intraoperative acute compartment syndrome of the upper limb secondary to extravasation

“…The British Orthopaedic Association guidelines dictate that re-evaluation should occur within 30 min and surgery should occur within the hour when a decision has been made to operate 44. There were only two (7%) cases of successful conservative treatment of compartment syndrome in the literature review,45 46 indicating the high likelihood of proceeding to surgery once a diagnosis has been made. Fasciotomies of the forearm and hand are commonly achieved by a curvilinear incision on the volar aspect, which extends into the hand for a carpal tunnel release 47.…”