Clinical results of decompressivedermotomy-fasciotomy

Scott B. Johnson, Fred A. Weaver, Albert E. Yellin, Rosemary Kelly, Madeline Bauer

Research output: Contribution to journalArticle

42 Scopus citations

Abstract

Seventy-three dermotomy-fasciotomies (DFs) wereperformed in 68 patients from 1986 to 1991. A database record was compiled on each patient. Variables included age, mode of injury, method of initial wound closure, and associated injuries. A multivariate stepwise logistic regression analysis was performed to determine which variables were associated with wound complications. Thirty-eight percent of patients who underwent DF developed wound complications. One hundred percent of those patients with postoperative arterial or graft thrombosis developed wound complications (P<0.01) as did 78% of those with thromboembolic disease (p<0.05). Conversely, only 5% of those who underwent closure of their DF wounds utilizing skin grafts developed wound complications (p<0.01) as compared with 51% of those who underwent secondary or primary closure only. Subsequent analysis of the remaining patients, excluding those with severe soft tissue injury, showed an association between location of DF (upper versus lower extremity) and the development of wound complications that approached statistical significance (p<0.06). DF is frequently necessary in the treatment of patients with compartment syndrome but is associated with significant morbidity. This study suggests that closure of DF wounds utilizing skin graft allows for continued osteofascial decompression while concomitantly minimizing invasive sepsis.

Original languageEnglish (US)
Pages (from-to)286-290
Number of pages5
JournalThe American Journal of Surgery
Volume164
Issue number3
DOIs
Publication statusPublished - Sep 1992

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ASJC Scopus subject areas

  • Surgery

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