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Compartment syndrome following prolonged pelvic surgery
P Peters1, S R Baker, P W Leopold
1Department of Surgery, United Medical School of Guy's Hospital, London, UK.
The British Journal of Surgery
|August 1, 1994
Summary
Prolonged pelvic surgery can cause compartment syndrome. Reversing table tilt during surgery significantly improves limb blood flow and may prevent this serious complication.
Area of Science:
- Surgical complications
- Vascular physiology
- Patient positioning
Background:
- Compartment syndrome is a rare but serious risk in prolonged pelvic surgery.
- Patient positioning, specifically limb angulation and elevation, may influence perfusion and intracompartmental pressure.
Observation:
- Ankle artery pressure decreased significantly in the Lloyd-Davies position with head-down tilt.
- Reversing table tilt restored ankle pressure, indicating improved limb perfusion.
- Intracompartmental pressure in the calf increased when lower limbs were placed in calf supports.
Findings:
- Head-down tilt during pelvic surgery reduces limb perfusion.
- Restoring limb elevation significantly improves perfusion.
- Calf supports increase intracompartmental pressure.
Implications:
- Reversing table tilt is crucial for maintaining limb perfusion during prolonged pelvic surgery.
- Adjusting patient positioning may mitigate the risk of compartment syndrome.
- Further research into optimal patient positioning is warranted to enhance surgical safety.