Original Research Article
Year: 2023 | Month: January | Volume: 10 | Issue: 1 | Pages: 719-724
DOI: https://doi.org/10.52403/ijrr.20230181
Closure of Fasciotomy Wound Using Dynamic Dermal Approximation Technique
Junaid Khurshid1, Avinash Gundavarapa2, Bashir Ahmad Bhat3, Umar Farooq Baba4
1Registrar Department of Plastic surgery, SMHS hospital Srinagar, Jammu and Kashmir, India-190011
2Registrar Department of Plastic surgery, SKIMS Srinagar, Jammu and Kashmir, India-190011
3Registrar Department of Plastic surgery, SMHS hospital Srinagar, Jammu and Kashmir, India-190011
4Additional Professor Department of Plastic surgery, SKIMS Srinagar, Jammu and Kashmir, India-190011
Corresponding Author: Dr Bashir Ahmad Bhat
ABSTRACT
Purpose: Compartment syndrome is a surgical emergency that is managed by a fasciotomy. However, it is associated with complications, including long hospital stay, wound infection and osteomyelitis need for further surgery for delayed wound closure or skin grafting, scarring, delayed bone healing, pain and nerve injury, permanent muscle weakness, chronic venous insufficiency, cosmetic problems, and an overall increased cost of care. A need for an early closure technique that will decrease all the above complications is described in this study.
Methods: This study was carried out in the Plastic Surgery Department of GMC Srinagar between from January 2020 to December 2022.This hospital-based study was done on compartment syndrome patients where fasciotomy was done and the wound closed by dynamic dermal suture approximation technique and results reviewed and outcome assessed.
Results: The technique was applied to a total of 12 patients with compartment syndrome. Ten of twelve patients in study were compartment syndrome of upper limb since severe lower limb trauma patients were excluded in view of need for other procedures. The wounds were divided into three classes as post burn, post trauma and post contrast extravasation. Wound closure was achieved in 75 percent of total cases and all of six post contrast extravasation compartment syndrome patients. Conclusion: Following a fasciotomy, wound closure is a topic that is often controversial. The preference for one technique over another is influenced by the availability of resources, institutional familiarity, and clinical scenarios. Dynamic dermal approximation sutures can be applied with minimal risk to most uncomplicated fasciotomies. The benefits are minimal complication, the best cosmetic outcome, and low cost. However, patients with a high risk of complications may need other methods.
Keywords: Compartment Syndrome, Fasciotomy, Wound Closure Techniques, Negative-Pressure Wound closure
[PDF Full Text]