Elevation as a treatment for fasciotomy wound closure

Bengezi, Omar; Vo, Anthony

doi:10.4172/plastic-surgery.1000823

Cited by 5 publications

(11 citation statements)

References 8 publications

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“…Delayed primary closure of large postfasciotomy wounds and/or skin and soft tissue defects following complex limb vascular injuries often represents a considerable clinical challenge. 8-10 The excessive and persistent muscle swelling may prevent adequate wound margin approximation and render delayed primary closure impossible due to extensive tension. A variety of techniques are available for achieving tension-free closure, including skin grafts, skin flaps, and tissue expansion.…”

Section: Discussionmentioning

confidence: 99%

“…10 However, it requires an additional operation, prolongs hospital stay, results in an additional wound, and complicates wound care at both sites. 8-11 Furthermore, there is always the possibility of graft failure. The final esthetic result is a thin, unappealing scar without sensation.…”

Section: Discussionmentioning

confidence: 99%

“…The final esthetic result is a thin, unappealing scar without sensation. 8 Negative pressure wound therapy with a VAC system is another popular approach in recent years. The reported wound closure time varies, with a mean of 6.7 days in one study and a mean of 11 days in another.…”

Section: Discussionmentioning

confidence: 99%

“…The reported wound closure time varies, with a mean of 6.7 days in one study and a mean of 11 days in another. 7-9,11-13 In addition, VAC may fail to provide adequate skin edge approximation for final closure, and as a result, an additional closing technique would be required. 8,13 Finally, tissue expansion is a well-known way of repairing soft tissue defects.…”

Section: Discussionmentioning

confidence: 99%

“…7-9,11-13 In addition, VAC may fail to provide adequate skin edge approximation for final closure, and as a result, an additional closing technique would be required. 8,13 Finally, tissue expansion is a well-known way of repairing soft tissue defects. 1,2 The principle of stretching wound margins for primary closure is commonly practiced and used for various skin defects, leading at times to excessive tension and complications.…”

Section: Discussionmentioning

confidence: 99%

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Management of Postfasciotomy Wounds and Skin Defects Following Complex Vascular Trauma to the Extremities Using the External Tissue Extender System

Karkos

Papoutsis

Giagtzidis

et al. 2018

The International Journal of Lower Extremity Wounds

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Management of large postfasciotomy wounds and/or skin and soft tissue defects after major vascular trauma to the extremities can be challenging. The External Tissue Extender (Blomqvist; ETE), a skin-stretching device, which consists of silicone tapes and plastic stoppers, approximates wound margins and facilitates delayed primary closure. We describe our experience with the use of ETE in 5 patients (4 males) with a total of 8 wounds (7 postfasciotomy, 1 soft tissue defect) over the past 12 years. The mean patient age was 32 (range 17-61) years. The wounds involved the lower limb in 3 patients and the upper limb in 2, whereas the injured arteries were the popliteal in 3, the axillary in 1, and the brachial in 1. The mean wound length was 24 cm (range 9-37 cm), and the mean number of ETE silicone tapes used per wound was 13 (range 5-19). The median duration of ETE therapy was 7 days (range 4-7). ETE therapy resulted in sufficient wound approximation to allow complete closure with conventional suturing in 7 out of the 8 wounds. Of these, one developed infection that required drainage, debridement, and resuturing. All wounds achieved satisfactory healing status and all limbs had been salvaged. In conclusion, the ETE is a useful, easy-to-use, and simple adjunct that may facilitate delayed primary closure of large postfasciotomy wounds or extensive skin and soft tissue defects following complex vascular trauma to the extremities.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Management of Postfasciotomy Wounds and Skin Defects Following Complex Vascular Trauma to the Extremities Using the External Tissue Extender System

Karkos

Papoutsis

Giagtzidis

et al. 2018

The International Journal of Lower Extremity Wounds

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How to Close a Limb Fasciotomy Wound

Kakagia

2014

The International Journal of Lower Extremity Wounds

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Early fasciotomy is the gold standard of prevention and treatment of compartment syndrome; however, the resulting wounds may significantly increase morbidity. To address the challenge of timely and safe closure of fasciotomy wounds, numerous methods have been described. A thorough search of medical databases PubMed/MEDLINE, ScienceDirect, SCOPUS, EMBASE, and Google Scholar was conducted for articles published between 1976 and 2013 using the search terms "limb fasciotomy wound closure," "open wound management," "skin stretching," and "fasciotomy complications." A total of 49 articles on technique descriptions, case reports of 2 or more patients, and of complications and comparative studies regarding limb fasciotomy wound closure were included. Details of the duration of treatment, advantages and disadvantages, direct cost, and complications were data extracted for each technique from the 49 studies included in this overview. Thorough knowledge of available techniques and their comparative advantages is essential for their clinical implementation, careful selection of patients, management of possible complications, decreased morbidity, and hospital recovery time and is also crucial for optimization of functional and aesthetic outcomes.

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Fasciotomy closure techniques

Jauregui

Yarmis

Tsai

et al. 2017

J Orthop Surg (Hong Kong)

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We evaluated the risks and success rates of the three major techniques for compartment syndrome fasciotomy closure by reviewing all literature published to date. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we systematically evaluated the Medline (PubMed) database until July 2015, utilizing the Boolean search sting "compartment syndrome OR fasciotomy closure." Two authors independently assessed all studies published in the literature to ensure validity of extracted data. The data was compiled into an electronic spreadsheet, and the wound closure rate with each technique was assessed utilizing a proportion random model effect. Success was defined as all wounds that could be closed without skin grafting, amputation, or death. The highest success rate was observed for dynamic dermatotraction and gradual suture approximation, whereas vacuum-assisted closure had the lowest complication rate.

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Elevation as a treatment for fasciotomy wound closure

Cited by 5 publications

References 8 publications

Management of Postfasciotomy Wounds and Skin Defects Following Complex Vascular Trauma to the Extremities Using the External Tissue Extender System

Management of Postfasciotomy Wounds and Skin Defects Following Complex Vascular Trauma to the Extremities Using the External Tissue Extender System

How to Close a Limb Fasciotomy Wound

Fasciotomy closure techniques

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