Fasciotomy

Fasciotomy is indicated for:

• acute compartment syndrome following trauma or successful revascularisation in patients with acute ischaemia;

• exercise related compartment syndrome.

Vertical incisions are made on the medial and lateral aspects of the leg. The superficial anterior, lateral and posterior compartments can be decompressed and by retraction of the gastrocnemius and soleus posteriorly the deep compartment can be entered. The skin should not be closed, as even this can cause compression in the grossly swollen limb, but a subcuticular prolene suture can be placed for later skin closure by simple traction on the suture ends.

Occasionally fasciotomy is required in the upper limb following revascularisation in acute ischaemia.

Figure 15.11. Diabetic digital gangrene.
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