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World Journal of Surgery

, Volume 21, Issue 3, pp 247–253 | Cite as

Complications and Nonclosure Rates of Fasciotomy for Trauma and Related Risk Factors

  • G.C. Velmahos
  • D. Theodorou
  • D. Demetriades
  • L. Chan
  • T.V. Berne
  • J. Asensio
  • E.E. Cornwell III
  • H. Belzberg
  • B.M. Stewart

Abstract. The objective of this study was to identify risk factors for the development of complications and unsatisfactory skin closure following fasciotomy for trauma. Risk factors included in the study are prolonged time from injury to fasciotomy, type of fasciotomy, site of injury, and kind of underlying injury. The study was a retrospective analysis of 100 consecutive fasciotomies done for trauma over a period of 38 months (December 1991 to January 1995) in a “level I” trauma center at a university-affiliated county teaching hospital. Ninety-four patients were eligible for analysis, 29 of whom (31%) developed complications at the fasciotomy site. The risk was increased for lower extremity versus upper extremity (34.3% versus 20.8%), prophylactic versus therapeutic (42.0% versus 24.6%), late (>8 hours) versus early (37% versus 25%), and vascular versus musculoskeletal (38.8% versus 22.2%) trauma cases. The same risk factors negatively influenced the ability to close the skin primarily. The four subgroups defined by vascular/nonvascular injury and upper/lower extremity site had significantly different nonclosure rates (

p = 0.043). The rate was highest among the vascular/lower extremity group (60.5%) and lowest among the nonvascular/upper extremity group (15.4%). We concluded that fasciotomies in lower extremities, the presence of underlying vascular injuries, fasciotomies performed prophylactically, and a time between the injury and fasciotomy of more than 8 hours are associated with an increased risk for local complications. The same factors are associated with an increased need for skin grafting the wound.

Keywords

Relate Risk Lower Extremity Retrospective Analysis Teaching Hospital Vascular Injury 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Société Internationale de Chirugie 1997

Authors and Affiliations

  • G.C. Velmahos
    • 1
  • D. Theodorou
    • 1
  • D. Demetriades
    • 1
  • L. Chan
    • 1
  • T.V. Berne
    • 1
  • J. Asensio
    • 1
  • E.E. Cornwell III
    • 1
  • H. Belzberg
    • 1
  • B.M. Stewart
    • 1
  1. 1.Department of Surgery, University of Southern California, Los Angeles County/University of Southern California Medical Center, 1200 N. State Street, Room 9900, Los Angeles, California 90033, U.S.A.US

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