• Archives of Plastic Surgery
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• 제46권1호
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• pp.69-74
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• 2019

Background Local symptoms and signs of snake envenomation mimic the clinical features of compartment syndrome. It is important to measure the intracompartmental pressure to diagnose compartment syndrome. In this study, we present our experiences of confirming compartment syndrome and performing fasciotomy in snakebite patients based on high intracompartmental pressure findings. Methods The medical records of patients who visited the trauma center of Wonju Severance Christian Hospital from January 2010 to December 2015 for the management of venomous snakebite were retrospectively reviewed. Starting in 2014, fasciotomy was performed in patients with an intracompartmental pressure of more than 40 mmHg in addition to the clinical symptoms of compartment syndrome. Results A total of 158 patients with snakebite came to the hospital within 48 hours for treatment. Most patients (110 patients) were bitten at the upper extremities (69.6%). Since 2014, 33 out of 59 patients were suspected to have compartment syndrome, and their intracompartmental pressures were measured. Seventeen of those patients had a high intracompartmental pressure (average, 49.6 mmHg; range, 37-88 mmHg), and fasciotomy was performed. Conclusions In this study, as many as 10.8% of all cases were in need of fasciotomy when compartment syndrome was diagnosed by measuring the intracompartmental pressure. Previously, it was reported that fasciotomy was not required in many cases of compartment syndrome originating from snakebite. However, some patients may develop very severe compartment syndrome, requiring fasciotomy.

• 대한화상학회지
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• 제23권1호
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• pp.13-19
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• 2020

Treatment of compartment syndrome is early decompressive fasciotomy to prevent dreadful sequelae of ischemic necrosis of muscles and nerves. We experienced one patient of impending or early compartment syndrome of right forearm and hand caused by a hot compress machine. We did immediate fasciotomy on forearm and late flap coverage with skin graft in this patient with good results.

• Journal of Trauma and Injury
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• 제36권1호
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• pp.60-64
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• 2023

Upper extremity vascular injuries occurring with acute compartment syndrome are very challenging to manage in an emergency context in resource-poor settings. The need to always recognize the likelihood of coexisting compartment syndrome guides surgeons to perform concomitant fasciotomy to ensure a better outcome. We managed three vascular injuries in the upper extremities in two patients with concomitant imminent compartment syndrome observed intraoperatively. The first injury was complete brachial artery disruption following blunt trauma, while the second and third injuries were radial and ulnar artery transection caused by sharp glass cuts. Both patients were treated with vascular repair and fasciotomy. Secondary wound coverage was applied with split-thickness skin grafting, and the outcomes were satisfactory. Concomitant fasciotomy potentially improves the outcomes of vascular repair in emergency vascular surgery and should be considered for all injuries with the potential for acute compartment syndrome.

• Journal of Trauma and Injury
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• 제24권1호
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• pp.56-59
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• 2011

Abdominal compartment syndrome (ACS) is a life-threatening disorder caused by rapidly increasing intra-abdominal pressure. ACS can result in multiorgan failure and carries a mortality of 60~70%. The treatment of choice in ACS is surgical decompression. There are very few reports of ACS and experience in Korea. We report 12-year-old male patient who developed an abdominal compartment syndrome due to traffic-accident-induced retroperitoneal hematomas, Which was successfully treated by performing a bedside emergency surgical decompression with open linea alba fasciotomy with intact peritoneum. When patients do not respond to medical therapy, a decompressive laparotomy is the last surgical resort. In patients with severe abdominal compartment syndrome, the use of a linea alba fasciotomy is an effective intervention to lower intra-abdominal hypertension (IAH) without the morbidity of a laparotomy. Use of a linea alba fasciotomy as a first-line intervention before committing to full abdominal decompression in patients with abdominal compartment syndrome improves physiological variables without mortality. Consideration for a linea alba fasciotomy as a bridge before full abdominal decompression needs further evaluation in patients with polytrauma abdominal compartment syndrome.

• Archives of Plastic Surgery
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• 제38권1호
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• pp.121-126
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• 2011

Purpose: Vaccum-assisted closure (VAC) has rapidly evolved into a widely accepted treatment of contaminated wounds, envenomations, infiltrations, and wound complications. This results in a sealed, moist environment where tissue is given the opportunity to survive as edema is removed and perfusion is increased. Many plastic surgeons now place a VAC device directly over the fasciotomy site at the time of the initial procedure. Large amounts of the fluid are withdrawn, and fasciotomies can be closed primarily sooner. This study was designed to observe the effect of VAC in preventing complications in snake bitten hands. Methods: In our study of three cases of snake bite, three of them underwent the VAC treatment & fasciotomy of the wound in the hand. This cases, the posterior compartment of the hand was bitten for a few days, releasing incisions were made of the posterior hand and 125 mmHg of continuous vacuum was applied to fasciomy incision site and the biting wound. The dressings were changed three times per week. Results: Our study examining the effects of applied vacuum in preventing snake bite wounds showed that the incidence of tissue necrosis and compartment syndrome was significantly lower for vacuum-treated wounds than for conservative wounds. Serum myoglobin, CK-MB, and CPK levels measured after fasciotomy incision were significantly decreased. We obtained satisfactory results from early dorsal fasciotomy, drainage of the edema with the VAC system, and then primary closure. The postoperative course was uneventful. Conclusion: Envenomation is a term implying that sufficient venom has been introduced into the body to cause either local signs at the site of the bite and/or systemic signs. Use of the vacuum-assisted closure device in snake bite can result in a decreased rate of tissue necrosis, lymphatic fluid collection, hemolytic fluid collection, and edema. Early fasciotomy of the dorsal hand and VAC apply is the alternative treatment of the snake bite.

• 대한족부족관절학회지
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• 제25권1호
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• pp.46-49
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• 2021

Acute compartment syndrome occurs when pressure increases within closed compartments due to injuries causing soft tissue damage. Delayed treatment can lead to undesirable consequences. This paper reports a three-year-old patient in whom a fasciotomy was performed successfully despite the potential side effects. Fasciotomy may be considered when the diagnosis and clinical symptoms of delayed compartment syndrome are clear. This study determined that the three-year-old patient would undergo a relatively smooth recovery compared to elderly patients of advanced age. Because the dorsalis pedis artery pulse was palpable, an emergency surgical treatment was performed to restore the damaged tissues and prevent further necrosis. The patient has shown a satisfactory recovery.

• 대한족부족관절학회지
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• 제17권3호
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• pp.165-173
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• 2013

Acute compartment syndrome of the lower leg and foot is a surgical emergency. The clinical symptoms is an important clue to diagnose compartment syndrome. In cases of ambiguous diagnosis, unconscious patients and children additionally need a intracompartmental pressure measuring. Immediate fasciotomy should be performed when clinical signs are obvious or when delta pressure is less than 30 mmHg or intracompartmental pressure is greater than 30 mmHg. Fasciotomy of the lower leg can be performed either by one lateral single incision or double incision, which of the foot mainly has a dorsal or medial incision. A delayed in diagnosis that leads to a delay in treatment can result in devastating disability. Acute compartment syndrome of the lower leg and foot is a relative rare but serious complication of which a surgeon should be aware.

• 대한족부족관절학회지
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• 제12권2호
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• pp.227-229
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• 2008

We experienced a case of an athlete with a painful mass on the distal peroneal musculature after sports activity, and diagnosed as the entrapment syndrome of superficial peroneal nerve. We treated the case with the mini-open and subcutaneous fasciotomy to release the entrapped peroneal nerve. We report the case with a review of the literature.

• 대한족부족관절학회지
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• 제4권2호
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• pp.93-99
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• 2000

Eleven patients with calcaneal fracture had 2 acute compartment syndrome of the feet and 9 late complication of the compartment syndrome of the feet. An interstitial pressure of more than 30 mmHg in either the central or interosseous compartment was considered pathologic and was treated by fasciotomy performed medially. Rigid claw toe deformity was treated by excision of the head and neck of the proximal phalanx, dorsal capsular release of the metatarsophalangeal joint, and lengthening of the extensor tendon. Patients were evaluated at a mean of 35 months(range, 21 - 44 months) after operation, and the examination was directed specifically toward symptoms and signs of myoneural ischemia, and walking pain. At follow-up, 2 patients with acute compartment syndrome of the foot had no evidence of myoneural ischemia, 9 patients with claw toe deformity had no pain with walking. Based on our clinical observations, we concluded that compartment syndrome of the foot may occur after the calcaneal fracture and fasciotomy is effective treatment for the prevention of the long term sequelae of this debilitating condition.

• 대한족부족관절학회지
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• 제3권1호
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• pp.12-18
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• 1999

Eleven patients with calcaneal fracture had 2 acute compartment syndrome of the feet and 9 late complication of the compartment syndrome of the feet. An interstitial pressure of more than 30 mmHg in either the central or interosseous compartment was considered pathologic and was treated by fasciotomy performed medially. Rigid claw toe deformity was treated by excision of the head and neck of the proximal phalanx, dorsal capsular release of the metatarsophalangeal joint, and lengthening of the extensor tendon. Patients were evaluated at a mean of 35 months(range, 21 - 44 months) after operation, and the examination was directed specifically toward symptoms and signs of myoneural ischemia, and walking pain. At follow -up, 2 patients with acute compartment syndrome of the foot had no evidence of myoneural ischemla, 9 patients with claw toe deformity had no pain with walking. Based on our clinical observations, we concluded that compartment syndrome of the foot may occur after the calcaneal fracture and fasciotomy is effective treatment for the prevention of the long term sequelae of this debilitating condition.