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Fasciotomy Wound Management and Closure

Potter, MAJ Benjamin K. MD*; Freedman, LTC Brett A. MD; Shuler, Michael S. MD

doi: 10.1097/BTO.0b013e31824885fa

While although full-compartment fasciotomy is unquestionably the best treatment for acute compartment syndrome, it is not a benign procedure. It leaves a large open wound that should be left open for at least 2 to 3 days. The outward pressure from swollen muscle and skin retraction serves to increase the dimensions of these wounds, which makes delayed primary closure challenging and often not possible in the most common fasciotomy site—the leg. This study discusses recent advances in the management of fasciotomy wounds that can reduce the morbidity of this procedure. Negative pressure wound therapy and dermatotraction are 2 important innovations, which improve overall outcomes.

*Walter Reed National Military Medical Center, Bethesda, MD

Landstuhl Regional Medical Center, Landstuhl, Germany

Athens Orthopedic Clinic, Athens, GA

The authors declare that they have nothing to disclose.

Address correspondence and reprint requests to LTC Brett A. Freedman, MD, CMR 402, PO Box 1503, APO, AE 09180. E-mail:

Received December 14, 2011

Accepted December 27, 2011

© 2012 Lippincott Williams & Wilkins, Inc.