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Published on: November 6, 2018
Iatrogenic Compartment Syndrome Secondary to Burn Dressing in a 2-Year-Old Child
Carlos Delgado-Miguel1, Antonio Jesus Muñoz-Serrano1, Miriam Miguel-Ferrero1
1Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain.
Insights
A tight burn dressing caused severe compartment syndrome in a child's finger. Prompt escharotomy restored blood flow, preventing permanent damage and potential limb loss.
Area of Science:
- Pediatric Surgery
- Burn Management
- Trauma Care
Background:
- Superficial partial-thickness thermal burns require careful dressing.
- Compressive dressings can pose risks if applied improperly.
Observation:
- A 2-year-old girl developed severe finger pain 48 hours after a compressive dressing for a thermal burn.
- A constrictive eschar formed at the finger base due to ischemia from the dressing.
Findings:
- Emergent lateral escharotomies successfully restored distal perfusion.
- Surgical debridement and skin grafting were necessary for wound closure.
Implications:
- This case highlights the risk of acute compartment syndrome from compressive burn dressings.
- Extreme caution is necessary to prevent iatrogenic injuries and potential loss of extremities.
Abstract:
We report a severe case of compartment syndrome due to a compressive burn dressing. An otherwise healthy 2-year-old girl presented at her local health center with a superficial partial-thickness thermal burn on the dorsum of the mid phalanx of the second finger of her right hand. A compressive dressing was applied solely to the affected finger. Forty-eight hours afterward, the patient presented in the emergency room with severe pain of the finger. After removal of the dressing, a circular constrictive eschar was observed at the base of the finger, secondary to ischemia due to the compressive dressing. Emergent lateral escharotomies were performed, with immediate recovery of distal perfusion. One week afterward, the patient underwent surgical debridement of the burn on the dorsum of her finger and escharectomy of the ischemic eschar at the base. The lesions were covered with partial-thickness skin grafts. This case shows that acute compartment syndrome can lead to severe sequelae, such as the loss of an extremity or body segment. We must take utmost care in all our actions to avoid any (negligent) act that could lead to severe or permanent damage to our patients.
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