Shoelace technique for delayed primary closure of fasciotomies.

Abstract:

:Performing a timely fasciotomy for compartment syndrome prevents ischemic injury to muscles and nerves. Fasciotomy entails incision of the overlying skin and investing fascia of the compartment, relieving pressure and enhancing tissue perfusion. Delayed primary closure is ideal, but because of skin edge retraction, the open wound must either heal secondarily or be closed with a split-thickness skin graft. The shoelace technique involves running a silastic vessel loop through skin staples placed at the skin edge along the initial fasciotomy incision. Daily tightening of the shoelace permits gradual reapproximation of the skin edges while compartment edema resolves. Closure using a simple suture or Steri-strip (3M Surgical Products, St. Paul, Minnesota) is then possible after 5 to 10 days. The shoelace technique allows for gradual primary closure of open fasciotomy wounds, thereby avoiding the morbidity and cost associated with skin graft or secondary closure.

journal_name

Am J Surg

authors

Berman SS,Schilling JD,McIntyre KE,Hunter GC,Bernhard VM

doi

10.1016/0002-9610(94)90130-9

subject

Has Abstract

pub_date

1994-04-01 00:00:00

pages

435-6

issue

4

eissn

0002-9610

issn

1879-1883

pii

0002-9610(94)90130-9

journal_volume

167

pub_type

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