title: Wound closure by dermatotraction after fasciotomy for acute compartment syndrome.
abstract: Intramuscular pressure (IMP) was measured in 16 patients during secondary wound closure by dermatotraction with external tissue extension (ETE). Secondary wound closure was done 4-16 days after fasciotomy for acute compartment syndrome. The traction between wound edges was 2.5 N in the first six patients and 3.5 N in the following 10 patients. Mean (SD) IMP was 6.9 (3.5) mmHg before wound closure. It increased to 12.3 (1.4) mmHg in the 2.5 N group and to 24.7 (7.0) mmHg in the 3.5 N group when dermatotraction was applied. Mean (SD) leg perfusion pressure in the 2.5 N group decreased by 7% to 69.3 (10.9) mmHg and in the 3.5 N group by 23% to 62.2 (7.4) mmHg. None of the patients needed a skin graft. We conclude that dermatotraction by ETE raises IMP intraoperatively sufficiently to preserve adequate limb perfusion pressures.
authors.affiliation: Department of Orthopaedics, Sahlgrenska University Hospital, Göteborg, Sweden.
authors.forename: P
authors.initials: P
authors.lastname: Wiger
authors.forename: G
authors.initials: G
authors.lastname: Blomqvist
authors.forename: J
authors.initials: J
authors.lastname: Styf
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003161:Compartment Syndromes / Q000601:surgery*; D062109:Dermatologic Surgical Procedures; D000071938:Fasciotomy; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000502:physiology; D011312:Pressure; D014143:Traction / Q000379:methods*