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Am Surg. 2008 Mar;74(3):217-20. Dynamic wound closure for
decompressive leg fasciotomy wounds. Singh N , Bluman E , Starnes B
, Andersen C . Source Vascular Surgery Service, Madigan Army
Medical Center, Tacoma, Washington 98431, USA.
[email protected] Abstract Decompressive fasciotomy for
preservation of lower extremity function and salvage is an
essential
technique in trauma. The wounds that result from the standard
two incision four-compartment legfasciotomy are often accompanied
by a wide soft tissue opening that in the face of truecompartment
syndrome are often impossible to close in a delayed primary
fashion. We describe atechnique using a device that allows for
dissipation of the workload across the wound marginallowing for
successful delayed primary closure. Consecutive patients who
presented to the 28th
Combat Support Hospital in Baghdad, Iraq with a diagnosis of
compartment syndrome of the leg,impending compartment syndrome of
the leg, or compartment syndrome of the leg recentlytreated with
fasciotomies were followed. All patients underwent placement of the
Canica dynamicwound closure device (Canica, Almonte, ON, Canada).
Eleven consecutive patients treated at acombat support hospital in
support of Operation Iraqi Freedom underwent
four-compartmentfasciotomies for penetrating injuries. There were
five patients that underwent a vascular repair[three superficial
femoral artery (SFA) injuries and two below knee popliteal artery
injuries] and sixpatients that had orthopedic injuries (three
comminuted tibial fractures, two fibula fractures, andone closed
pilon fracture). Patients returned to the operating room within 24
hours for washoutand wound inspection. Mean initial wound size was
8.1 cm; mean postplacement size was 2.7 cm;average time to closure
was 2.6 days. All patients were able to undergo primary wound
closure ofthe medial incision and placement of the Canica device
over the lateral incision. Ten of the 11patients (91%) could be
closed in delayed primary fashion after application of the device.
In ourseries of patients with penetrating wartime injuries and
compartment syndrome of the leg we havefound the use of this
dynamic wound closure device to be extremely successful and
expedient.
http://www.ncbi.nlm.nih.gov/pubmed/18376685http://www.ncbi.nlm.nih.gov/pubmed?term=Singh%20N%5BAuthor%5D&cauthor=true&cauthor_uid=18376685http://www.ncbi.nlm.nih.gov/pubmed?term=Bluman%20E%5BAuthor%5D&cauthor=true&cauthor_uid=18376685http://www.ncbi.nlm.nih.gov/pubmed?term=Starnes%20B%5BAuthor%5D&cauthor=true&cauthor_uid=18376685http://www.ncbi.nlm.nih.gov/pubmed?term=Andersen%20C%5BAuthor%5D&cauthor=true&cauthor_uid=18376685http://www.ncbi.nlm.nih.gov/pubmed?term=Andersen%20C%5BAuthor%5D&cauthor=true&cauthor_uid=18376685http://www.ncbi.nlm.nih.gov/pubmed?term=Andersen%20C%5BAuthor%5D&cauthor=true&cauthor_uid=18376685http://www.ncbi.nlm.nih.gov/pubmed?term=Andersen%20C%5BAuthor%5D&cauthor=true&cauthor_uid=18376685http://www.ncbi.nlm.nih.gov/pubmed?term=Starnes%20B%5BAuthor%5D&cauthor=true&cauthor_uid=18376685http://www.ncbi.nlm.nih.gov/pubmed?term=Starnes%20B%5BAuthor%5D&cauthor=true&cauthor_uid=18376685http://www.ncbi.nlm.nih.gov/pubmed?term=Starnes%20B%5BAuthor%5D&cauthor=true&cauthor_uid=18376685http://www.ncbi.nlm.nih.gov/pubmed?term=Bluman%20E%5BAuthor%5D&cauthor=true&cauthor_uid=18376685http://www.ncbi.nlm.nih.gov/pubmed?term=Bluman%20E%5BAuthor%5D&cauthor=true&cauthor_uid=18376685http://www.ncbi.nlm.nih.gov/pubmed?term=Bluman%20E%5BAuthor%5D&cauthor=true&cauthor_uid=18376685http://www.ncbi.nlm.nih.gov/pubmed?term=Singh%20N%5BAuthor%5D&cauthor=true&cauthor_uid=18376685http://www.ncbi.nlm.nih.gov/pubmed?term=Singh%20N%5BAuthor%5D&cauthor=true&cauthor_uid=18376685http://www.ncbi.nlm.nih.gov/pubmed?term=Singh%20N%5BAuthor%5D&cauthor=true&cauthor_uid=18376685http://www.ncbi.nlm.nih.gov/pubmed/18376685http://www.ncbi.nlm.nih.gov/pubmed/18376685http://www.ncbi.nlm.nih.gov/pubmed/18376685http://www.ncbi.nlm.nih.gov/pubmed/18376685
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Publication Date: 5/16/2012 JBJS Acute compartment syndrome of
the forearm . Andrew D Duckworth; Sarah E Mitchell; Samuel G
Molyneux; Timothy O White; Charles M Court-
Brown; Margaret M McQueen
BACKGROUND: The aims of this study were to document our
experience with acute forearmcompartment syndrome and to determine
the risk factors for the need for split-thickness skin-grafting and
the development of complications after fasciotomy.
METHODS: We identified from our trauma database all patients who
underwent fasciotomy for anacute forearm compartment syndrome over
a twenty-two-year period. Diagnosis was made withuse of clinical
signs in all patients, with compartment pressure monitoring used as
a diagnosticadjunct in some patients. Outcome measures were the use
of split-thickness skin grafts and theidentification of
complications following forearm fasciotomy.
RESULTS: There were ninety patients in the study cohort, with a
mean age of thirty-three years(range, thirteen to eighty-one years)
and a significant male predominance (eighty-two patients; p
