scholarly journals Can Extravasation Injury Cause Subcutaneous Compartment Syndrome of the Hand?

2017 ◽  
Vol 3 ◽  
pp. 2513826X1772825
Author(s):  
Victor W. Wong ◽  
Philip J. Hanwright ◽  
Michele A. Manahan
Keyword(s):  
Compartment Syndrome ◽  
Tissue Perfusion ◽  
Acute Compartment Syndrome ◽  
Tissue Loss ◽  
Rapid Improvement ◽  
Subcutaneous Space ◽  
Cutaneous Perfusion ◽  
Compartment Pressures

Background: Compartment syndrome of the hand is a well-described phenomenon with potentially devastating consequences. Although numerous mechanisms have been proposed, the extravasation of peripheral intravenous (IV) fluids remains a relatively rare etiology. Objective: Surgical dogma mandates emergent decompressive fasciotomies in the presence of hand dysfunction and impending tissue loss from supraphysiologic compartment pressures. The role of the subcutaneous space in acute compartment syndrome remains unclear. Methods: In this report, we present a case of a dorsal hand IV extravasation leading to an acute compartment syndrome of the subcutaneous space. Results: An emergent skin-only incision was used for decompression, with immediate improvement in symptoms and no long-term adverse sequelae. Discussion: The subcutaneous space appears capable of sustaining supraphysiologic pressures that impair cutaneous perfusion. This closed anatomic space can be readily decompressed, resulting in rapid improvement in soft tissue perfusion. However, its role in contributing to acute compartment syndrome of the hand requires further research. Conclusion: We propose consideration of the subcutaneous space as a distinct hand compartment and advocate selective compartment release when prudent.

scholarly journals The Pathophysiology, Diagnosis and Current Management of Acute Compartment Syndrome

2014 ◽  
Vol 8 (1) ◽  
pp. 185-193 ◽  
Author(s):  
James Donaldson ◽  
Behrooz Haddad ◽  
Wasim S Khan
Keyword(s):  
Compartment Syndrome ◽  
Tissue Perfusion ◽  
Surgical Decompression ◽  
Acute Compartment Syndrome ◽  
Definitive Treatment ◽  
Interstitial Pressure ◽  
Compartment Pressure ◽  
Current Management ◽  
Ischaemic Damage

Acute compartment syndrome (ACS) is a surgical emergency warranting prompt evaluation and treatment. It can occur with any elevation in interstitial pressure in a closed osseo-fascial compartment. Resultant ischaemic damage may be irreversible within six hours and can result in long-term morbidity and even death. The diagnosis is largely clinical with the classical description of ‘pain out of proportion to the injury’. Compartment pressure monitors can be a helpful adjunct where the diagnosis is in doubt. Initial treatment is with the removal of any constricting dressings or casts, avoiding hypotension and optimizing tissue perfusion by keeping the limb at heart level. If symptoms persist, definitive treatment is necessary with timely surgical decompression of all the involved compartments. This article reviews the pathophysiology, diagnosis and current management of ACS.

scholarly journals Bilateral compartment syndrome of the lower limbs after urological surgery in the lithotomy position: a clinical case

2019 ◽  
Vol 18 ◽  
Author(s):  
José Maciel Caldas dos Reis ◽  
Lauro José Mendes Queiroz ◽  
Pablo Ferreira Mello ◽  
Renan Kleber Costa Teixeira ◽  
Fábio de Azevedo Gonçalves
Keyword(s):  
Compartment Syndrome ◽  
Wound Closure ◽  
Early Recognition ◽  
Acute Compartment Syndrome ◽  
Lower Limbs ◽  
Lithotomy Position ◽  
Activity Levels ◽  
Urological Surgery ◽  
Baseline Activity

Abstract Acute compartment syndrome of the lower extremities after urological surgery in the lithotomy position is a rare but potentially devastating clinical and medicolegal problem. We report the case of a 67-year-old male who underwent laparoscopic prostatectomy surgery to treat cancer, spending 180 minutes in surgery. Postoperatively, the patient developed acute compartment syndrome of both legs, needing emergency bilateral four-compartment fasciotomies, with repeated returns to the operating room for second-look procedures. The patient also exhibited delayed wound closure. He regained full function within 6 months, returning to unimpaired baseline activity levels. This report aims to highlight the importance of preoperative awareness of this severe complication which, in conjunction with early recognition and immediate surgical management, may mitigate long-term adverse sequelae and improve postoperative outcomes.

Evaluation of Strength Recovery after Traumatic Acute Compartment Syndrome of the Thigh. A Case Study

2017 ◽  
Vol 19 (4) ◽  
pp. 0-0
Author(s):  
Alban Fouasson-Chailloux ◽  
Pierre Menu ◽  
Marc Dauty
Keyword(s):  
Compartment Syndrome ◽  
Acute Compartment Syndrome ◽  
Intramuscular Pressure ◽  
Rehabilitation Care ◽  
Fracture Reduction And Fixation ◽  
Strength Recovery ◽  
Prompt Diagnosis

Acute compartment syndrome of the thigh is an underestimated serious pathology which can cause long term morbidities. The management, recovery and follow-up of the case of a 20-year-old Caucasian man, who presented an acute compartment syndrome of the thigh, are described. After femoral fracture reduction and fixation by nail, intramuscular pressure measurements confirmed the diagnosis before treatment by fasciotomies. 12-months’ follow-up showed the presence of neurological femoral complications and physical impairment in spite of rehabilitation care. Because compartment syndrome of the thigh after a trauma is rare but potentially devastating, prompt diagnosis is required for performing early fasciotomies.

Correlation Between Muscle Oxygenation and Compartment Pressures in Acute Compartment Syndrome of the Leg

2010 ◽  
Vol 92 (4) ◽  
pp. 863-870 ◽  
Author(s):  
Michael S Shuler ◽  
William M Reisman ◽  
Tracy L Kinsey ◽  
Thomas E Whitesides ◽  
E Mark Hammerberg ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Acute Compartment Syndrome ◽  
Muscle Oxygenation ◽  
Compartment Pressures

Monitoring and interpreting compartment pressures in acute compartment syndrome

Trauma ◽  
2012 ◽  
Vol 14 (2) ◽  
pp. 163-168 ◽  
Author(s):  
Tom Barker ◽  
Mark Midwinter ◽  
Keith Porter
Keyword(s):  
Compartment Syndrome ◽  
Acute Compartment Syndrome ◽  
Compartment Pressures

scholarly journals Extravasation injury leading to acute compartment syndrome in a child: The vital role of pulse oximetry in early detection and management

2018 ◽  
Vol 28 (4) ◽  
pp. 95-98 ◽  
Author(s):  
Daniel Rodger ◽  
Jacinda Hammerschlag
Keyword(s):  
Early Detection ◽  
Compartment Syndrome ◽  
Patient Outcomes ◽  
Vital Role ◽  
Acute Compartment Syndrome ◽  
Case Study Approach ◽  
Study Approach ◽  
Vascular Compromise

Acute compartment syndrome as a result of an extravasation injury is rare. The perioperative environment presents a unique risk that may contribute to more serious patient outcomes. Using a case study approach we report that the placement of a pulse oximeter on the cannulated limb can provide the first sign of vascular compromise.

Evaluation of Clinical and Venous Blood Parameters as Surrogate Indicators in Assessing the Need for Fasciotomy in Lower Limb Compartment Syndrome

2021 ◽  
pp. 153473462110590
Author(s):  
Rituparna Dasgupta ◽  
Nishith M. Paul Ekka ◽  
Arghya Das ◽  
Vinod Kumar
Keyword(s):  
Compartment Syndrome ◽  
Lower Limb ◽  
Venous Blood ◽  
Acute Compartment Syndrome ◽  
Neurological Deficits ◽  
Fisher Exact Test ◽  
Compartment Pressure ◽  
Exact Test ◽  
Significant Difference ◽  
Compartment Pressures

Acute compartment syndrome in the lower limb, a surgical emergency, may cause ischemic damage to muscles and neurological deficits leading to loss of function of the limb which may even require amputation, thus drastically affecting the quality of life of a patient. Fasciotomy for decompression is suggested when the differential pressure in the compartment of the leg is ≤30 mm Hg. However, compartment pressure measurement is not always feasible. Surgeons often find themselves in a dilemma in deciding the right treatment option for the patient: fasciotomy or conservative management. Since there is no universally accepted reference standard for the diagnosis of acute compartment syndrome at present, there is a need for definitive diagnostic variables so as to not delay fasciotomy in patients who need it, as well as to avoid unnecessary fasciotomies, especially when compartment pressures cannot be measured. In this observational study including 71 patients, based on the compartment pressures of the affected limb, treatment was done either with fasciotomy or conservative approach, and various clinical and biochemical parameters were evaluated in between these two groups. Statistically significant difference was found in the venous blood gas parameters between patients managed conservatively and with fasciotomy (MANOVA, P = .001). The results revealed the association of lower venous blood bicarbonate levels (independent sample t test, P = .021) and the presence of paresthesia (Fisher exact test, P = .0016) with the fasciotomy group. Also, pain on passive stretching of the affected limb was found to be significantly associated with a delta pressure of ≤30 mm Hg in any compartment (Fisher exact test, P = .002). These variables may thus be used as an alternative to the measurement of compartment pressure to assess the requirement of fasciotomy.

Comparing the methods of measuring compartment pressures in acute compartment syndrome

2003 ◽  
Vol 21 (2) ◽  
pp. 143-145 ◽  
Author(s):  
Annemarie Uliasz ◽  
Jay T. Ishida ◽  
Jason K. Fleming ◽  
Loren G. Yamamoto
Keyword(s):  
Compartment Syndrome ◽  
Acute Compartment Syndrome ◽  
Compartment Pressures
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