What is Fasciotomy for Compartment Syndrome
Fasciotomy for compartment syndrome is a surgical procedure that is performed 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 your muscles begin to swell inside the fascia, blood flow to the muscles can be cut off, and your muscles may die if the pressure is not relieved. This condition is called compartment syndrome.
Trauma, such as a crushing injury or a complicated 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.
Fasciotomy for compartment syndrome is usually performed as an urgent procedure. It is important to have the procedure as soon as possible to help prevent muscle death.
Tell a health care provider about:
- Any allergies you have.
- All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
- Any problems you or family members have had with anesthetic medicines.
- Any blood disorders you have.
- Any surgeries you have had.
- Any medical conditions you have.
- Whether you are pregnant or may be pregnant.
- Any tobacco use.
What are the risks?
Generally, this is a safe procedure. However, problems may occur, including:
- Bleeding.
- Scarring.
- Muscle weakness or loss of the muscle.
- Pain.
- Nerve damage that causes loss of feeling.
- Infection.
- Need for repeated procedures.
What happens during the procedure?
The procedure may vary among health care providers and hospitals. Your exact procedure will depend on where your compartment syndrome is located. In general, the following occurs during this procedure:
- An IV tube will be inserted into one of your veins.
- You will be given a medicine to make you fall asleep (general anesthetic).
- You may be given antibiotics to help prevent infection.
- Your surgeon will make one or more cuts (incisions) in the area where the compartment syndrome is located.
- Your incisions may not be closed during surgery. Instead, they may be covered with bandages (dressings) until the pressure in the area decreases.
What happens after the procedure?
- Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
- You will be given medicine for pain.
- You may continue to receive fluids and antibiotics through the IV.
- Your incision will be checked and your dressing will be changed regularly.
- You will be re-evaluated in the operating room in the next few days. At this time, further treatments or wound closure will be performed. This may include stitches (sutures) and a procedure to cover an area of damaged or missing skin with a piece of healthy skin (skin graft).
Fasciotomy for Compartment Syndrome, Care After
Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.
What can I expect after the procedure?
After the procedure, it is common to have:
- Pain.
- Itching.
- Stiffness.
- Numbness or tingling.
- Clear or yellow fluid draining from the incision.
Follow these instructions at home:
Incision care
- Follow
instructions from your surgeon about:
- How to take care of your incision.
- When and how you should change your bandage (dressing). If your incision is open, a wound care specialist may come to your home to change the dressing.
- When you should remove your dressing.
- Keep the incision area dry. Do nottake baths, swim, or use a hot tub until your surgeon approves. Ask your surgeon when you can take a shower.
- Check
your incision every day for signs of infection. Watch for:
- Redness, swelling, or pain.
- Pus or blood.
- Fluid drainage that continues for longer than one week.
Managing pain, stiffness, and swelling
- Move your fingers or toes often to avoid stiffness and swelling.
- Raise (elevate) the injured area above the level of your heart as much as possible.
Activity
- Ask your surgeon what activities are safe for you.
- If the procedure was done on your leg or foot, do notstand or walk until your surgeon says you may.
- If the procedure was done on your hand or arm, avoid any activity that involves lifting, carrying, gripping, or twisting until your surgeon says you may.
General instructions
- Take over-the-counter and prescription medicines only as told by your surgeon. Do nottake aspirin or other NSAIDs unless your surgeon has approved. These types of medicine increase your risk of bleeding.
- Keep all follow-up visits as told by your surgeon. This is important.
- You may need to see a physical therapist or occupational therapist. This will help your recovery. Do any exercises as instructed by your physical or occupational therapist.
- Do notuse any tobacco products, including cigarettes, chewing tobacco, or e-cigarettes. Tobacco can delay healing. If you need help quitting, ask your health care provider.
Contact a health care provider if:
- You have a fever.
- Your pain is not controlled with medicine.
- Your incision becomes red, swollen, or painful.
- You have fluid, including blood or pus, coming from your incision for longer than one week.
- You feel nauseous or vomit and it does not go away.
Get help right away if:
- You have increased swelling in your arm or leg.
- You have increasing or severe pain.
- You have chest pain.
- You have trouble breathing.
- You lose feeling in your arm or leg.
