Optimising Wound Closure Following a Fasciotomy: A narrative review

Sultan Qaboos Univ Med J. 2019 Aug;19(3):e192-e200. doi: 10.18295/squmj.2019.19.03.004. Epub 2019 Nov 5.

Abstract

Compartment syndrome is a surgical emergency that could be resolved by a fasciotomy. However, performing substantial skin incisions may lead to life-threatening complications. This narrative review aimed to present the available methods of wound closure and preferential factors for using each technique. Viable and non-infected wounds were most often treated by gradual approximation techniques, such as the simple or modified shoelace technique, the prepositioned intracutaneous suture or several commercially-available mechanical devices. In addition, applying negative pressure therapy was found to be feasible, particularly when combined with approximation techniques. Skin grafting was reserved for severely-dehiscent wounds while other non-invasive approaches were considered for other subsets of patients with inadvisable surgical interventions. Treatment decision should be made in view of the patient's condition, ease of application, availability of resources, cost of treatment and aesthetic outcomes.

Keywords: Compartment Syndrome; Fasciotomy; Negative-Pressure Wound Therapy; Wound Closure Techniques.

Publication types

  • Review

MeSH terms

  • Compartment Syndromes / prevention & control*
  • Compartment Syndromes / therapy
  • Dermatologic Surgical Procedures / methods*
  • Fasciotomy* / rehabilitation
  • Humans
  • Negative-Pressure Wound Therapy / methods*
  • Skin Transplantation / methods
  • Suture Techniques
  • Tissue Expansion / methods
  • Wound Healing / physiology*