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The use vacuum therapy in wound healing after fasciotomy in compartment syndrome — case report and literature review
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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.
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.
Keywords
fasciotomy, lower limb ischaemia, NPWT, compartment syndrome, VAC dressing
About this articleTitle
The use vacuum therapy in wound healing after fasciotomy in compartment syndrome — case report and literature review
Journal
Issue
Article type
Case report
Pages
158-163
Published online
2017-03-14
Page views
1510
Article views/downloads
2519
DOI
10.5603/AA.2016.0015
Bibliographic record
Acta Angiologica 2016;22(4):158-163.
Keywords
fasciotomy
lower limb ischaemia
NPWT
compartment syndrome
VAC dressing
Authors
Maria K. Blonska-Staniec
Anna E. Barczak
Anna Garus
Norbert Balchanowski
Jaroslaw P. Miszczuk
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