Fasciotomy in peripheral vascular surgery

Patman, R. Don; Thompson, J E

doi:10.1097/00006534-197203000-00050

Cited by 21 publications

(10 citation statements)

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“…Many techniques for decompressing the lower extremity have been described. 9 Our choice has been four-compart¬ ment decompression through separate generous medial and lateral incisions or by single lateral incision with fibulectomy. Following vascular repair, the muscle beds again must be carefully examined to assess the thoroughness of fasciotomy.…”

Section: Resultsmentioning

confidence: 99%

Peripheral Vascular Trauma From Close-Range Shotgun Injuries

Meyer¹,

Lim²,

Schuler³

et al. 1985

Arch Surg

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Section: Resultsmentioning

confidence: 99%

Peripheral Vascular Trauma From Close-Range Shotgun Injuries

Meyer¹,

Lim²,

Schuler³

et al. 1985

Arch Surg

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“…The incidence of IRS occurs up to 20% in acute ischaemic limbs that have been revascularised (6). In these cases an emergency fasciotomy is required to reduce the compartment pressure (7–9). Primary conservative closure of fasciotomy wounds is difficult and can cause wound oedema (10).…”

Section: Introductionmentioning

confidence: 99%

Comparison of vacuum‐assisted closure device and conservative treatment for fasciotomy wound healing in ischaemia‐reperfusion syndrome: preliminary results

Karaca

Çıkırıkçıoğlu

Uçkay

et al. 2011

International Wound Journal

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Ischaemia-reperfusion syndrome (IRS) is a condition that may require early fasciotomy. In the past, fasciotomies ultimately required prolonged hospitalisation. Vacuum-assisted closure (VAC) therapy system is an innovative method which promotes wound healing by reducing wound oedema, increasing microcirculation, and stimulation of granulation tissue. The aim of this retrospective study was to compare the VAC treatment with the conservative treatment of the fasciotomy wound until definitive surgical closure. The researchers retrospectively identified 15 patients, 3 females and 12 males, with a mean age of 69 years, who underwent a fasciotomy between January 2003 and December 2009 at the University Hospital of Geneva. All of the fasciotomies performed on the patients were on account of IRS. Seven patients were subjected to wound treatment using the VAC-system device and eight patients underwent treatment through the usual conservative method. The data were analysed by comparing the operative wound size, length of time for wound closure and duration of hospital stay in both groups. The number of days after fasciotomy until surgical wound closure in the VAC-system group (n = 7) ranged from 8 to 13 days with a mean of 11 days. The wound size at the day of closure was decreased in length by a mean of 58% (range 29-67%) and in diameter by a mean of 56% (range 33-75%). The duration of hospital stay for this group ranged from 12 to 18 days with a mean of 14 days. No signs of infections were observed and no re-operation was required after first closure. In the conservative group (n = 8), the time to wound closure ranged between 12 and 20 days with a mean of 15 days. The wound size was decreased in length by a mean of 40% (range 32-53%) and in diameter by a mean 46% (range 30-70%). The mean duration of hospital stay was 18·5 days. Three of the patients in the conservative treatment group manifested wound infection during the course of the treatment. VAC device could be a new standard for treatment of fasciotomy wound. VAC therapy is a recent innovation and becoming more and more a necessary complementary therapy to hasten wound healing. In our preliminary study, the VAC-system device showed significantly reduction of the wound size, decreased tissue oedema, duration of hospital days and improvement of granulation tissue.

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“…Compartment syndrome of the upper extremity has multiple etiologies, including fracture, intensive use of muscles, vascular ischemia, venous obstruction, crush or electrical injury, and also iatrogenic and idiopathic causes [7,17]. Emergent fasciotomy is indicated to reduce the compartment pressure [10,11,15].…”

Section: Introductionmentioning

confidence: 99%

The Use of an Innovative Device for Wound Closure after Upper Extremity Fasciotomy

Medina

Spears

Mitra

2007

Hand (New York, N,Y.)

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Introduction The purpose of this paper is to evaluate the Silver Bullet Wound Closure Device (SBWCD, Boehringer Laboratories, Norristown, PA), a new device for delayed primary closure of fasciotomy wounds. Materials and Methods A retrospective review was performed over a period of 36 months of all patients with an upper extremity fasciotomy that could not be closed primarily. Cases that underwent fasciotomy closure with the SBWCD were separated from the patients that had a split thickness skin graft (STSG). Results Seven patients had their wound closed with the SBWCD within 10 days (mean of 7.4 days). The seven patients that underwent STSG had their wound closed in an average of 8.4 days. The average number of days between the day of the fasciotomy incision and the date of the placement of the SBWCD was 1.9 days. STSGs were placed on the fasciotomy wounds on an average of 10.3 days after the date of the fasciotomy incision. We found that the SBWCD allowed for starting to approximate the edges of the fasciotomy wound at an earlier time when compare to STSG (2.1 vs 10.3 days).Conclusions We feel that the SBWCD as a one-stage procedure provides a consistent and efficacious way to manage upper extremity fasciotomy wounds while minimizing the morbidity associated with STSG. Elimination of a secondstage procedure reduces hospital costs. Our findings may help to inform surgeons about an available alternative when an upper extremity fasciotomy wound is not amenable to primary closure.

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Fasciotomy in peripheral vascular surgery

Cited by 21 publications

References 0 publications

Peripheral Vascular Trauma From Close-Range Shotgun Injuries

Peripheral Vascular Trauma From Close-Range Shotgun Injuries

Comparison of vacuum‐assisted closure device and conservative treatment for fasciotomy wound healing in ischaemia‐reperfusion syndrome: preliminary results

The Use of an Innovative Device for Wound Closure after Upper Extremity Fasciotomy

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