Fasciotomy

Fasciotomy

When the pressure is down, the fasciotomy is covered with a skin graft.
ICD-9 82.12 83.14

Fasciotomy or fasciectomy is a surgical procedure where the fascia is cut to relieve tension or pressure commonly to treat the resulting loss of circulation to an area of tissue or muscle.[1] Fasciotomy is a limb-saving procedure when used to treat acute compartment syndrome. It is also sometimes used to treat chronic compartment stress syndrome. The procedure has a very high rate of success, with the most common problem being accidental damage to a nearby nerve.

A forearm fasciotomy prior to skin grafting.

Indications

Compartment syndrome is one of the conditions where a fasciotomy may be indicated. People who are likely to have injuries needing a fasciotomy include the following:

Complications

A delay in performing the procedure can lead to neurovascular complications or lead to the need for amputation of a limb.[1] Complications can also involve the formation of scar tissue after the operation. A thickening of the surgical scars can result in the loss of mobility of the joint involved. This can be addressed through occupational or physical therapy.

Process

Fasciotomy in the limbs is usually performed by a surgeon under general or regional anesthesia. An incision is made in the skin, and a small area of fascia is removed where it will best relieve pressure.

Plantar fasciotomy is an endoscopic procedure. The physician makes two small incisions on either side of the heel. An endoscope is inserted in one incision to guide the physician. A tiny knife is inserted in the other. A portion of the fascia near the heel is removed. The incisions are then closed.

Wound covered with a skin graft once pressure is relieved.

In addition to scar formation, there is a possibility that the surgeon may need to use a skin graft to close the wound. Sometimes when closing the fascia again in another surgical procedure, the muscle is still too large to close it completely. A small bulge is visible, but is not harmful. It takes much time to heal and in some cases takes several months.

See also

References

  1. 1 2 Dente CJ, Wyrzykowski AD, Feliciano DV (October 2009). "Fasciotomy". Current Problems in Surgery. 46 (10): 779–839. PMID 19735797. doi:10.1067/j.cpsurg.2009.04.006. Retrieved 2012-07-30.
  2. ↑ "Compartment syndrome: MedlinePlus Medical Encyclopedia". Nlm.nih.gov. Retrieved 2014-03-08.
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