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Fasciotomy closure techniques.

Julio J Jauregui1, Samantha J Yarmis2, Justin Tsai2

  • 11 Department of Orthopaedics, University of Maryland Medical Center, Baltimore, MD, USA.

Journal of Orthopaedic Surgery (Hong Kong)
|February 9, 2017
PubMed
Summary

This systematic review compares fasciotomy closure techniques for compartment syndrome. Dynamic dermatotraction and gradual suture approximation showed the highest success rates, while vacuum-assisted closure had fewer complications.

Keywords:
closurecompartment syndromecomplicationsfasciotomywound closure

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Area of Science:

  • Orthopedics
  • Trauma Surgery
  • Wound Healing

Background:

  • Compartment syndrome requires fasciotomy for limb salvage.
  • Effective fasciotomy closure is crucial to prevent complications and optimize outcomes.
  • Various techniques exist, but comparative data on risks and success rates are limited.

Purpose of the Study:

  • To systematically review and compare the risks and success rates of the three major techniques for compartment syndrome fasciotomy closure.
  • To identify the most effective closure method based on literature evidence.

Main Methods:

  • Systematic literature review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
  • Searched Medline (PubMed) database until July 2015 using "compartment syndrome OR fasciotomy closure."
  • Independent assessment of studies by two authors; data compiled and analyzed using a proportion random model effect.

Main Results:

  • Dynamic dermatotraction and gradual suture approximation demonstrated the highest wound closure rates without need for skin grafting, amputation, or death.
  • Vacuum-assisted closure exhibited the lowest complication rate among the evaluated techniques.
  • Success was defined as complete wound closure without adverse sequelae.

Conclusions:

  • Dynamic dermatotraction and gradual suture approximation are superior for achieving successful fasciotomy closure in compartment syndrome.
  • Vacuum-assisted closure offers a favorable safety profile with reduced complications.
  • Further research may refine optimal closure strategies based on specific patient and injury factors.