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Does oedema following lower limb revascularisation cause compartment syndromes?
Annals of the Royal College of Surgeons of England
|November 1, 1988
Summary
Lower limb swelling after vascular surgery is common but not indicative of compartment syndrome. Measurements suggest this edema is subcutaneous, not compartmental, advising against routine pressure monitoring unless fasciotomy is considered.
Area of Science:
- Vascular Surgery
- Orthopedic Surgery
- Physiology
Background:
- Lower limb swelling is a known complication after reconstructive vascular surgery.
- The precise nature and impact of this edema on limb physiology remain unclear.
Purpose of the Study:
- To investigate the characteristics of leg edema following femoropopliteal bypass surgery.
- To differentiate between subcutaneous and compartmental edema and assess the risk of compartment syndrome.
Main Methods:
- Prospective study involving 15 patients undergoing femoropopliteal bypass.
- Measurement of anterior compartment pressures and calf circumference in operated and non-operated limbs.
- Statistical analysis using paired t-tests to compare limb measurements.
Main Results:
- All patients exhibited significant lower limb swelling post-surgery compared to the non-operated limb.
- Increased anterior compartment pressures were observed on postoperative days 3 and 4 in the operated limb.
- No patient presented with clinical or pressure-based indicators of compartment syndrome.
Conclusions:
- Postoperative edema following lower limb vascular reconstruction appears to be primarily subcutaneous.
- Routine compartment pressure monitoring may not be necessary unless fasciotomy is contemplated.