The use vacuum therapy in wound healing after fasciotomy in compartment syndrome — case report and literature review

Abstract

Fasciotomy (opening of the fascial compartments) is one of the main and most effective methods used for emergency treatment of compartment syndrome. Post-fasciotomy wounds may be the cause of the patient’s prolonging hospitalization and may be a challenge in terms of their treatment. In order to avoid potential complications, the wound should be closed as quickly as possible — once the compartment’s pressure on the muscle has been relieved. A large size of the surgical wounds constitutes a significant care problem as it may substantially prolong their healing period and increase infection risk. The use of skin transplants may lead to complications and rigid scars both in the place of harvest and the post-fasciotomy wound; therefore immediate wound closure to allow healing by primary intention is a better option for the patient. This technique allows limiting complications and gives better aesthetic effects; however, it may often be difficult to apply due to the significant limb swelling and shrinking or necrosis of the wound edges. In this paper the authors present a case of a 58-year-old man after the open fasciotomy for whom Negative Pressure Wound Therapy (NPWT) was applied as a method auxiliary to compartment syndrome treatment and shortening wound healing period. In the summary, the use of NPWT in facilitating the treatment of compartment syndrome and healing of fasciotomy wound was discussed briefly, based on the literature review.