Related Experiment Video
Updated: Feb 7, 2026

Evaluating Postural Control and Lower-extremity Muscle Activation in Individuals with Chronic Ankle Instability
Published on: September 18, 2020
Management of extremity fasciotomy sites prospective randomized evaluation of two techniques
Laura S Johnson1, Mitchell Chaar2, Chad G Ball3
1Medstar Washington Hospital Center, Washington, DC, United States; Grady Memorial Hospital and Department of Surgery, Emory University School of Medicine, Atlanta, GA, United States.
Introduction:
Morbidity from the treatment of extremity compartment syndrome is underappreciated. Closure technique effectiveness has yet to be definitively established.
Methods:
A randomized non-blinded prospective study was performed involving patients who underwent an extremity fasciotomy following trauma. Shoelace wounds were strapped with vessel loops under tension and VAC wounds were treated with a standard KCI VAC dressing. After randomization, patients returned to the OR every 96 h until primarily closed or skin grafted.
Results:
21 patients were consented for randomization with 11 (52%) successfully closed at the first re-operation. After interim analysis the study was closed early with 5/5 (100%) of wounds treated with the shoelace technique closed primarily and only 1/9 (11%) of VAC wounds closed primarily (p = 0.003). Overall primary closure was achieved in 74% of patients.
Conclusions:
Aggressive attempts at wound closure lead to an increased early closure rate. For wounds that remain open after the first re-operation, a simple shoelace technique is more successful than a wound VAC for achieving same hospital stay skin closure.
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