A practical approach to compartmental syndromes. Part I. Definition, theory, and pathogenesis

This discussion of the pathogenesis of compartmental syndromes may be summarized as follows: Compartmental syndromes may arise from any cause of increased tissue pressure. The tissue pressure of importance in considering the circulatory changes produced by a compartmental syndrome is the net force per unit area exerted on vessel walls. Increased local tissue pressure increases local venous pressure, decreasing the local arteriovenous gradient. This reduces local blood flow and oxygenation, compromising local tissue function and viability. The tolerance of tissue for increased pressure varies with local arterial pressure, the duration of pressure application, and possibly with the local metabolic needs of the tissue. Prompt diagnosis and complete surgical decompression are essential to preserve the viability and function of tissues threatened by a compartmental syndrome.