This paper is only available as a PDF. To read, Please Download here.
Seventy-three dermotomy-fasciotomies (DFs) wereperformed in 68 patients from 1986
to 1991. A database record was compiled on each patient. Variables included age, mode
of injury, method of initial wound closure, and associated injuries. A multivariate
stepwise logistic regression analysis was performed to determine which variables were
associated with wound complications.
Thirty-eight percent of patients who underwent DF developed wound complications. One
hundred percent of those patients with postoperative arterial or graft thrombosis
developed wound complications (P<0.01) as did 78% of those with thromboembolic disease
(p<0.05). Conversely, only 5% of those who underwent closure of their DF wounds utilizing
skin grafts developed wound complications (p<0.01) as compared with 51% of those who
underwent secondary or primary closure only. Subsequent analysis of the remaining
patients, excluding those with severe soft tissue injury, showed an association between
location of DF (upper versus lower extremity) and the development of wound complications
that approached statistical significance (p<0.06).
DF is frequently necessary in the treatment of patients with compartment syndrome
but is associated with significant morbidity. This study suggests that closure of
DF wounds utilizing skin graft allows for continued osteofascial decompression while
concomitantly minimizing invasive sepsis.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The American Journal of SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Fasciotomy after trauma to the extremities.Am J Surg. 1988; 156: 533-536
- Lower extremity compartment syndromes: treatment.in: Mubarek SJ Hargens AR Compartment syndromes and Volkmann's contracture. WB Saunders, Philadelphia1981: 149-154
- Upper extremity compartment syndromes: treatment.in: Mubarek SJ Hargens AR Compartment syndromes and Volkmann's contracture. WB Saunders, Philadelphia1981: 136-138
- Fasciotomy—an appraisal of controversial issues.Arch Surg. 1981; 116: 1474-1481
- Early fasciotomy for acute clinically evident post-traumatic compartment syndrome.Am J Surg. 1989; 158: 36-39
- Diagnosis and management of compartmental syndromes.J Bone Joint Surg. 1980; 62 (AM): 286-291
- Cellular changes with graded limb ischemia and reperfusion.J Vasc Surg. 1984; 1: 536-540
- Fasciotomy in peripheral vascular surgery.Arch Surg. 1970; 101: 663-672
- Tissue pressure measurements as a determinant for the need for fasciotomy.Clin Orthop. 1975; 113: 43-51
- Transfibular route for fasciotomy of the leg.in: Proceedings of the American Academy of Orthopaedic Surgeons. J Bone Joint Surg. 49A. 1967: 1022-1023
- Fibulectomy-fasciotomy: an important adjunct in the management of lower extremity arterial trauma.J Trauma. 1971; 11: 365-380
- Compartmental syndromes in which the skin is the limiting boundary.Clin Orthol. 1975; 113: 65-68
Article info
Footnotes
**Presented at the 20th Annual Meeting of the Society for ClinicalVascular Surgery, Orlando, Florida, March 25–29, 1992.
Identification
Copyright
© 1992 Reed Publishing USA. Published by Elsevier Inc.
