Medical knowledge, Patient Education
Fasciotomy for Acute Compartment Syndrome
Fasciotomy for acute compartment syndrome is a surgery that is done to quickly relieve pressure around a muscle and restore blood flow to the area. Muscles are surrounded by a thin but tough layer of tissue (fascia). If muscles begin to swell inside the fascia, blood flow to the muscles can be cut off, and the muscles may die if the pressure is not relieved. This condition is called acute compartment syndrome. Trauma, such as a crushing injury or a broken bone, is the most common cause. The most common areas to have compartment syndrome are the leg below the knee and the arm below the elbow.
In fasciotomy surgery, incisions are made in the fascia to relieve pressure and allow the muscle to expand. This is an urgent procedure that is done as soon as possible to prevent muscle death. In some cases, fasciotomy may be done along with the repair of bone, arteries, and veins in the affected area.
Tell a health care provider about:
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Any allergies you have.
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All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
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Any problems you or family members have had with anesthetic medicines.
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Any blood disorders you have.
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Any surgeries you have had.
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Any medical conditions you have.
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Whether you are pregnant or may be pregnant.
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Any tobacco use.
What are the risks?
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Bleeding.
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Scarring.
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Muscle weakness or loss of the muscle.
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Pain.
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Nerve damage that causes a loss of feeling.
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Infection.
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The need for repeated procedures.
What happens before the procedure?
Acute compartment syndrome is a medical emergency that requires surgery to relieve pressure. This surgery needs to be done right away.
First-aid treatment
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Treating any injury.
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Loosening or removing any cast, bandage, or external wrap that may be causing pain.
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Raising, or elevating, the painful arm or leg to the same level as the heart.
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Giving oxygen.
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Giving fluids through an IV.
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Giving pain medicine.
General instructions
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Follow instructions from your health care provider about eating and drinking restrictions. When the diagnosis of acute compartment syndrome is made, you may be asked not to eat or drink anything until after the surgery.
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Ask your health care provider:
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How your surgery site will be marked.
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What steps will be taken to help prevent infection. These may include:
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Removing hair at the surgery site.
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Washing skin with a germ-killing soap.
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Receiving antibiotic medicine.
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What happens during the procedure?
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An IV will be inserted into one of your veins.
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You will be given one or more of the following:
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A medicine to help you relax (sedative).
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A medicine to make you fall asleep (general anesthetic).
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A medicine that is injected into an area of your body to numb the area (local anesthetic).
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Your surgeon will make one or more incisions in the area where the acute compartment syndrome is located.
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Your incisions may not be closed during surgery. They may be covered with:
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Bandages (dressings) until the pressure in the area decreases.
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A dressing that uses a sponge or foamlike material to suck fluid out of your incisions (negative pressure wound therapy, or NPWT).
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The procedure may vary among health care providers and hospitals.
What happens after the procedure?
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Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until you leave the hospital or clinic.
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Your kidney function and urine will be checked for signs of ongoing breakdown of muscle tissue.
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You will be given medicine for pain.
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You may continue to get fluids and antibiotics through the IV.
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Your incision or incisions will be checked often.
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You will be checked again in the operating room in the next few days. At that time, further treatments or wound closure will be done. This may include stitches (sutures) or skin graft. A skin graft is a procedure to cover an area of damaged or missing skin with a piece of healthy skin.
Summary
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Acute compartment syndrome occurs when muscles begin to swell inside the tough layer of tissue (fascia) that surrounds them. Blood flow to the muscles can be cut off, and the muscles may die if the pressure is not relieved.
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Fasciotomy is a surgery to quickly relieve pressure around a muscle and restore blood flow to the area.
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In fasciotomy surgery, an incision is made in the fascia to relieve pressure and allow the muscle to expand.
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This is an urgent procedure that needs to be done right away.
This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.
