Shoelace Technique Plus Negative-Pressure Wound Therapy Closure in Fasciotomy Wounds
Engin Eceviz1, Hüseyin Bilgehan Çevik
1Engin Eceviz, MD, is Assistant Professor, University of Health Sciences, Department of Orthopaedics and Traumatology, Kartal Dr Lütfi Kirdar Research and Training Hospital, İstanbul, Turkey. Hüseyin Bilgehan Çevik, MD, is Assistant Professor, University of Health Sciences, Department of Orthopaedics and Traumatology, Dişkapi Yildirim Beyazit Training and Research Hospital, Ankara. The authors have disclosed no financial relationships related to this article. Submitted June 21, 2019; accepted in revised form October 31, 2019.
Background:
Fasciotomy incision closure is often performed with skin grafts that can lead to cosmetic and functional complications after surgical intervention. Because fasciotomy incisions do not result in skin loss, the authors hypothesized that better closure can be achieved by reducing tissue edema with negative-pressure wound therapy (NPWT) and reducing stress on the skin with the shoelace surgical technique.
Methods:
This 1-year prospective study included eight patients with acute compartment syndrome after extremity fractures and/or blunt injuries. Patients were treated with fasciotomies closed with the shoelace technique and NPWT for wound margin approximation. The NPWT device was changed every second day; the shoelace traction tension was tightened at the same time.
Main Results:
The mean time from fasciotomy to wound closure was 11.8 days (range, 5-30 days). There was no need for a skin graft or flap in any patient.
Conclusions:
The shoelace technique plus NPWT may be successful in closing skin fasciotomies after acute compartment syndrome without causing additional morbidity.
