Timing of surgical intervention for compartment syndrome in different body region: systematic review of the literature

Catena, Fausto; Improta, Mario; Picetti, Edoardo; Vergano, Luigi Branca; Catena, Fausto; Angelis, Nicola De; Bertolucci, Andrea; Kirkpatrick, Andrew W.; Sartelli, Massimo; Fugazzola, Paola; Tartaglia, Dario; Chiarugi, Massimo

doi:10.1186/s13017-020-00339-8

Cited by 17 publications

(16 citation statements)

References 95 publications

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“…Muscles can tolerate a condition of reduced vascular supply for a time period of no more than 6 to 8 hours. Regarding the limbs there is evidence supporting that the time threshold after which necrosis occurs, is 8 hours [6]. There are though case series reporting a good outcome from fasciotomies which were performed within 12 hours [11].…”

Section: Treatmentmentioning

confidence: 99%

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Hand Compartment Syndrome

Stavrakakis¹,

Magarakis²,

Tosounidis³

2021

A Comprehensive Review of Compartment Syndrome [Working Title]

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Compartment syndrome is defined by high pressures in a closed myofascial compartment, which affects initially the muscles and later the nerves and vessels. The hand is rarely affected, but if treated suboptimally, it results to a permanent loss of function. Eleven compartments are included in the hand and wrist. Diagnosis of compartment syndrome of the hand remains challenging. Pain out of proportion of injury and excessive swelling should raise suspicion towards a compartment syndrome. Intracompartmental pressure measurement contributes to the diagnosis, but it is not always reliable. Once the diagnosis of acute compartment syndrome has been made, decompression of all compartments is mandatory, in order to achieve a good outcome. Failing to manage this emergent condition properly leads to a significant hand disability. Our chapter includes the following sections: 1. Introduction. A brief description of the hand compartment syndrome is presented. 2. Anatomy. Special considerations regarding hand compartments are presented, 3. Etiology. 4. Diagnosis. Signs and symptoms are reported, as well as guidelines of the technique of intracompartmental pressure measurement. 5. Treatment. Faciotomies’ indications and operative technique are described in details. 6. Conclusion. Appropriate figures of the clinical image and surgical decompression are presented as well.

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Section: Treatmentmentioning

confidence: 99%

“…Intervention varies from simple actions, such as splitting a tight cast, to a surgical decompression [2]. Correct timing of fasciotomies is of paramount importance, in order to achieve a good functional outcome [6].…”

Section: Introductionmentioning

confidence: 99%

Hand Compartment Syndrome

Stavrakakis¹,

Magarakis²,

Tosounidis³

2021

A Comprehensive Review of Compartment Syndrome [Working Title]

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“…It is generally accepted that it is better to perform a fasciotomy that ultimately proves unnecessary than to perform a fasciotomy late in a symptomatic patient and risk the consequences of neglected ECS ( Gourgiotis et al, 2007 ; Taylor et al, 2012 ). Performing a fasciotomy in the late stages of the syndrome (more than 8 h after onset) is contraindicated, as it will not benefit the patient and significantly increases the risk of infection ( Coccolini et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Extremity compartment syndrome: A review with a focus on non-invasive methods of diagnosis

Novák

Penhaker

Raška

et al. 2022

Front. Bioeng. Biotechnol.

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The article deals with an overview of acute extremity compartment syndrome with a focus on the option of non-invasive detection of the syndrome. Acute extremity compartment syndrome (ECS) is an urgent complication that occurs most often in fractures or high-energy injuries. There is still no reliable method for detecting ECS. The only objective measurement method used in clinical practice is an invasive measurement of intramuscular pressure (IMP). The purpose of this paper is to summarize the current state of research into non-invasive measurement methods that could allow simple and reliable continuous monitoring of patients at risk of developing ECS. Clinical trials are currently underway to verify the suitability of the most studied method, near-infrared spectroscopy (NIRS), which is a method for measuring the local oxygenation of muscle compartments. Less explored methods include the use of ultrasound, ultrasound elastography, bioimpedance measurements, and quantitative tissue hardness measurements. Finding a suitable method for continuous non-invasive monitoring of the syndrome would greatly improve the quality of care for patients at risk. ECS must be diagnosed quickly and accurately to prevent irreversible tissue damage that can occur within hours of syndrome onset and may even warrant amputation if neglected.

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Section: Introductionmentioning

confidence: 99%

“…Compartment syndrome occurs when increased pressure inside a closed anatomical space compromises tissue perfusion [ 1 ]. In the human body there are multiple inextensible anatomical compartments in which the increase in pressure causes changes in homeostasis by directly or indirectly decreasing the vascular supply to the tissues [ 1 ]. Examples of anatomical spaces are the cranial box, the orbit, the thoracic cavity, the pericardium, the abdominal cavity, and the musculoskeletal compartments of the upper and lower limbs.…”

Section: Introductionmentioning

confidence: 99%

Abdominal Compartment Syndrome—When Is Surgical Decompression Needed?

et al. 2021

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Compartment syndrome occurs when increased pressure inside a closed anatomical space compromises tissue perfusion. The sudden increase in pressure inside these spaces requires rapid decompression by means of surgical intervention. In the case of abdominal compartment syndrome (ACS), surgical decompression consists of a laparostomy. The aim of this review is to identify the landmarks and indications for the appropriate moment to perform decompression laparotomy in patients with ACS based on available published data. A targeted literature review was conducted on indications for decompression laparotomy in ACS. The search was focused on three conditions characterized by a high ACS prevalence, namely acute pancreatitis, ruptured abdominal aortic aneurysm and severe burns. There is still a debate around the clinical characteristics which require surgical intervention in ACS. According to the limited data published from observational studies, laparotomy is usually performed when intra-abdominal pressure reaches values ranging from 25 to 36 mmHg on average in the case of acute pancreatitis. In cases of a ruptured abdominal aortic aneurysm, there is a higher urgency to perform decompression laparotomy for ACS due to the possibility of continuous hemorrhage. The most conflicting recommendations on whether surgical treatment should be delayed in favor of other non-surgical interventions come from studies involving patients with severe burns. The results of the review must be interpreted in the context of the limited available robust data from observational studies and clinical trials.

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Timing of surgical intervention for compartment syndrome in different body region: systematic review of the literature

Cited by 17 publications

References 95 publications

Hand Compartment Syndrome

Hand Compartment Syndrome

Extremity compartment syndrome: A review with a focus on non-invasive methods of diagnosis

Abdominal Compartment Syndrome—When Is Surgical Decompression Needed?

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