Compartment syndrome and fasciotomy in vascular surgery. A review of 57 cases.
OBJECTIVE
To investigate the occurrence of compartment syndrome and the results of fasciotomy in vascular surgical patients.


METHODS
Retrospective study of case records from 1980-1994.


METHODS
Fifty-seven limbs in 53 patients had fasciotomies following surgical revascularisation. Fifty-three (93%) limbs were acutely ischaemic, while four (7%) had undergone elective vascular surgery. Forty-four (77%) limbs had signs of compartment syndrome, while 13 (23%) fasciotomies were prophylactic.


METHODS
The fasciotomies were done as subcutaneous procedures (n = 40), as double-incision fasciotomies (n = 11), or by an unknown method (n = 6). The skin incisions were closed primarily in 26 (46%) cases, delayed primarily in 11 (19%) cases, and by skin grafting in eight cases (14%).


RESULTS
Five (13%) subcutaneous fasciotomies required revision. Surgical debridement was required in four (7%) limbs. At discharge, 36 (68%) patients had kept their limbs, 11 (21%) patients were amputated, and six (11%) had died. No complications relating to the fasciotomies were observed.


CONCLUSIONS
Compartment syndrome is usually related to acute ischaemia and rarely following elective vascular surgery. Subcutaneous fasciotomy does not always ensure sufficient decompression of all four lower leg compartments. Complications related to fasciotomy are rare.
Jensen
S L
SL
Department of Vascular Surgery, Aalborg Hospital, Denmark.
Sandermann
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000706:statistics & numerical data; D002423:Cause of Death; D002648:Child; D003161:Compartment Syndromes / Q000209:etiology* / Q000601:surgery; D003646:Debridement; D000071938:Fasciotomy; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000401:mortality; D007511:Ischemia / Q000209:etiology; D007866:Leg / Q000098:blood supply / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014656:Vascular Surgical Procedures / Q000009:adverse effects*