Archives of Surgery · 1975 · 192 citations · 0 references
MedicineSurgeryVeterinary SurgeryHemodynamic ManagementSmall Animal SurgeryWound HealingCompartment SyndromePressure DistributionTissue Perfusion AssessmentCompartment Syndrome FasciotomyCompartment Syndrome ManagementDiagnostic Pressure MeasurementDirect MeasurementFasciotomy Decision CriteriaIncreased Tissue PressureTissue Pressure Dynamics
Diagnosing closed compartment syndrome is challenging because clinical signs are hard to quantify, and fasciotomies are often performed empirically after irreversible tissue injury, yet the syndrome’s key factor is elevated tissue pressure that must be relieved to restore perfusion. The study aims to improve management by directly measuring intra‑compartmental pressure. The authors present a simple, inexpensive, and reliable method for pressure measurement, and canine studies confirm that tissue injury worsens with longer ischemia.
The decision to perform a fasciotomy for a suspected closed compartment syndrome is frequently difficult. The signs and symptoms commonly used in establishing the diagnosis often cannot be adequately quantitated. In the past, fasciotomies frequently were undertaken after tissue injury was irreversible. More recently, the trend has been to do the procedure either empirically or with minimal evidence of ischemia in order to forestall tissue damage. The principal factor present in the closed compartment syndrome is increased tissue pressure. The effectiveness of fasciotomy is based on relief of this pressure and reestablishment of tissue perfusion. The most logical means to improve our ability to deal with the syndrome would be direct measurement of the pressure within the closed compartment. We have devised a method that is simple, readily available, inexpensive, and reliable. <h3>RESEARCH</h3> Studies involving dogs have shown that tissue injury increases as the duration of the ischemia increases.<sup>1</sup>