Fasciotomy done for vascular trauma at a tertiary care centre in Sri Lanka<\/p>\n
Author ;<\/p>\n
JOEL ARUDCHELVAM<\/p>\n
DOI\u00a0https:\/\/doi.org\/10.62474\/UHXT2336<\/a><\/p>\n ORCID\u00a0https:\/\/orcid.org\/0000-0002-4371-4527<\/a><\/p>\n ABSTRACT Compartment syndrome is a major factor contributing to limb loss and poor outcome following lower limb vascular injuries.<\/p>\n Method Results Discussion References<\/p>\n 1. Anatomic location of penetrating lowerextremity trauma predicts compartment syndrome development. Gonzalez RP, Scott W, Wright A, et al. 2009, Am J Surg , Vol. 197, pp. 371\u20135.\u00a0http:\/\/Anatomic location of penetrating lowerextremity trauma predicts compartment syndrome development. Gonzalez RP, Scott W, Wright A, et al. 2009, Am J Surg , Vol. 197, pp. 371\u20135. https:\/\/doi.org\/10.1016\/j.amjsurg.2008.11.013<\/a> Fasciotomy done for vascular trauma at a tertiary care centre in Sri Lanka Author ; JOEL ARUDCHELVAM DOI\u00a0https:\/\/doi.org\/10.62474\/UHXT2336 ORCID\u00a0https:\/\/orcid.org\/0000-0002-4371-4527 ABSTRACT Introduction Compartment syndrome is a major factor contributing to limb loss and poor outcome following lower limb vascular injuries. Method This is a retrospective study done on patients with vascular injuries and undergone fasciotomy at...<\/p>","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[9,1,6],"tags":[],"article-type":[22],"class_list":["post-1","post","type-post","status-publish","format-standard","hentry","category-2024-issue-1","category-category-01","category-volume-1"],"acf":[],"_links":{"self":[{"href":"https:\/\/traumaseclanka.health.gov.lk\/sljt\/wp-json\/wp\/v2\/posts\/1","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/traumaseclanka.health.gov.lk\/sljt\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/traumaseclanka.health.gov.lk\/sljt\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/traumaseclanka.health.gov.lk\/sljt\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/traumaseclanka.health.gov.lk\/sljt\/wp-json\/wp\/v2\/comments?post=1"}],"version-history":[{"count":8,"href":"https:\/\/traumaseclanka.health.gov.lk\/sljt\/wp-json\/wp\/v2\/posts\/1\/revisions"}],"predecessor-version":[{"id":594,"href":"https:\/\/traumaseclanka.health.gov.lk\/sljt\/wp-json\/wp\/v2\/posts\/1\/revisions\/594"}],"wp:attachment":[{"href":"https:\/\/traumaseclanka.health.gov.lk\/sljt\/wp-json\/wp\/v2\/media?parent=1"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/traumaseclanka.health.gov.lk\/sljt\/wp-json\/wp\/v2\/categories?post=1"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/traumaseclanka.health.gov.lk\/sljt\/wp-json\/wp\/v2\/tags?post=1"},{"taxonomy":"article-type","embeddable":true,"href":"https:\/\/traumaseclanka.health.gov.lk\/sljt\/wp-json\/wp\/v2\/article-type?post=1"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
\nIntroduction<\/p>\n
\nThis is a retrospective study done on patients with vascular injuries and undergone fasciotomy at the accident service operation theatre (ASOT) at the national hospital of Sri Lanka (NHSL), during a period of one year. Cases with Incomplete documentation were excluded. Data on patient demographics, time of injury, and time of fasciotomy, associated fractures, muscle viability and outcome were collected.<\/p>\n
\nA total of 30 cases were included. 26 (86%) were males. Nine (30%) were upper limb and 21(70%) were lower limb fasciotomy. The cause for limb injuries were road traffic accidents (RTA) in 18 (58.1%), trap gun injury in five (16.1%). All the fasciotomy were done prior to revascularization. 19 (63.3%) had fractures (12 (63%) were open and seven (36%) closed). six (20%) fasciotomy were done for compartment syndrome, 24 (80%) were done prophylactically. Three patients with compartment syndrome had open fractures (50%) and three had closed fractures (50%). On fasciotomy, in four cases all four leg compartment muscles were non-viable, two had non-viable three compartments and one patient had non-viable two compartments. The mean delay in patients who had all compartments viable was 3.7 hours (2-6.5) and the mean delay in patients with three or four non-viable compartments was 12.2hours (7-24). This difference was statistically significant (p-0.0001). The fasciotomy delay was also significant
\n(p-0.0001) between the patients who had an amputation and limb salvage. Overall amputation rate was 20% in this series. Mean time of delay from admission to NHSL to the time of fasciotomy was 1.8 hours (1-3.5). Mean time of injury to time of fasciotomy was 5.42 hours (2-24).<\/p>\n
\nNumber of non-viable compartments is significantly associated with the duration between time of injury to time of fasciotomy(P-0.0001). Therefore we suggest early fasciotomy before transfer.<\/p>\n
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\n4. Acute compartment syndrome in tibial diaphyseal fractures. McQueen MM, Christie J, Court-Brown CM. Acute compartment syndrome in tibial diaphysealfractures. J Bone Joint Surg Br 1996 and 95\u20138.., 78:. 1996, J Bone Joint Surg Br , Vol.78, pp. 95\u20138.\u00a0https:\/\/pubmed.ncbi.nlm.nih.gov\/8898136\/<\/a>
\n5. Risk factors for compartment syndrome in traumatic brachial artery injuries: an institutional experience in 139 patients. Kim JY, Buck DW 2nd, Forte AJ, SubramanianVS, Birman MV, Schierle CF, Kloeters O, Mattox KL, Wall MJ, Epstein MJ. 6, 2009,J Trauma, Vol. 67, pp. 1339-44.\u00a0https:\/\/doi.org\/10.1097\/ta.0b013e318197b999<\/a>
\n6. Incidence and predictors for the need for fasciotomy after extremity trauma: a 10-year review in a mature level I trauma centre. Branco BC, Inaba K, BarmparasG, Schn\u00fcriger B, Lustenberger T, Talving P, Lam L, Demetriades D. 10, 2011, Injury,Vol. 42, pp. 1157-63\u00a0https:\/\/doi.org\/10.1016\/j.injury.2010.07.243<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"