Muscles, nerves, and blood vessels are separated into areas called compartments. The compartments are wrapped in a strong sheet of tissue called fascia. Fluid buildup or swelling can increase pressure in the compartment. This can slow or block the flow of blood in the area and damages nerves. The loss of blood flow can also cause the death of tissue in the area. The pressure can also painfully squeeze tissue including nerves.
Fasciotomy is used to immediately release the pressure in these compartments. Releasing the pressure will improve blood flow and stop or slow damage to the local tissue. It may be used to treat:
There may be some differences in how a fasciotomy is done based on the part of the body and severity.
In general, the procedure is similar for a leg or arm. One incision will be made in the skin over the compartments. The incision will cover the length of the limb between 2 joints. The fascia, just under the skin, is then cut in the same length. If dead tissue is present it will be removed.
Loose stitching will be placed over the area but the wound will remain open. The doctor will gradually close the wound once the swelling has passed.
Until the wound is closed, the area will be wrapped in a dressing. The wound will be monitored with frequent trips to the operating room to have:
The dressing removed
Any additional dead tissue removed
The wound cleaned
The stitches tightened to slowly close the area as swelling goes down
A new dressing applied
Complete closure may take up to 2 weeks. A skin graft may be needed if the area cannot be completely closed.
Immediately After Procedure
You will be taken to the recovery room and monitored.
How Long Will It Take?
The length of the procedure will depend on how much damage there is.
How Much Will It Hurt?
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
Average Hospital Stay
You may be in the hospital for up to 3 days. If you have any problems, you may need to stay longer.
At the Hospital
Right after the procedure, you will be in a recovery room where your blood pressure, pulse, and breathing will be monitored. Recovery may also include:
IV fluids to keep you hydrated
Urine tests to assess the breakdown of muscle tissue and kidney function
You will also be shown how to use supportive devices like crutches or a sling.
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
Washing their hands
Wearing gloves or masks
Keeping your incisions covered
There are also steps you can take to reduce your chances of infection such as:
Washing your hands often and reminding visitors and healthcare providers to do the same
Reminding your healthcare providers to wear gloves or masks
Not allowing others to touch your incisions
You will not be able to use the affected limb. Supportive devices, like a splint or crutches, will be needed to support the limb during recovery.
Call Your Doctor
Contact your doctor if your recovery is not progressing as expected or you develop complications such as:
Signs of infection, including fever or chills
Increasing pain that cannot be controlled with the medications you were given
Increasing swelling that makes the splint and/or dressing tight and painful
Excessive bleeding that is difficult to stop
Numbness, tingling, or burning pain
Loss of feeling or inability to move the affected limb
You injure the affected limb
A feeling of tightness or fullness in the area
Loss of muscle control
New or unexpected symptoms
If you have signs of acute compartment syndrome or you think you have a different emergency, call for emergency medical services right away.
Bowyer MW. Lower extremity fasciotomy: indications and techniques. Curr Trauma Rep. 2015;1(1):35-44. Available at: http://link.springer.com/article/10.1007/s40719-014-0002-7.
Chandraprakasam T, Kumar RA. Acute compartment syndrome of the forearm and hand. Indian J Plastic Surg. 2011;44(2):212-218.
Mabvuure NT, Malahias M, Hindocha S, Khan W, Juma A. Acute compartment syndrome of the limbs: current concepts and management. Open Orthop J. 2012;6:535-543.
Rao M. Indications and techniques of lower extremity fasciotomy. Case presentation from Kings County Hospital Center. SUNY Downstate Medical Center website. Available at: http://www.downstatesurgery.org/files/cases/indications_techniques_lef.pdf.
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