Back to Annual Meeting

Background: Acute compartment syndrome (ACS) is treated operatively with a fasciotomy. A fasciotomy is the treatment of choice to relieve tension, improve perfusion, and therefore prevent ischemic injury to the nerve or muscle. However, the fasciotomy results in a large open wound that may be a challenge to heal.
At our institution the standard of care is a novel approach to fasciotomy site closure utilizing an external tissue expander to facilitate delayed primary closure. In this paper we present a consecutive case series of twenty-eight cases of fasciotomy wounds in which twenty-six wounds were closed using external tissue expansion with the DermaClose external tissue expander. In addition we analyze the cost effectiveness of continuous external tissue expansion for closure of fasciotomy wounds as compared to more tradition techniques.
Methods: Twenty-eight patients were taken to the OR for closure of their fasciotomy sites using the DemaClose external tissue expander.
Results: Twenty-six achieved a tension-free closure without the need for additional flaps or skin grafts. The initial wound size for all cases ranged from a length of 9 to 25 cm and a width of 4 to 15cm. The median time to closure was 4 days.
The patients treated with DermaClose had 72% overall dollar savings compared to advanced moist wound technology. These savings were realized through shorter hospital stays, less operating room time, and less nursing care.
Conclusions: Although essential for treatment of ACS, fasciotomies and subsequent wound healing contribute to health care cost and inpatient length of stay. The management of compartment syndrome and fasciotomy wound management is efficacious and cost effective when DermaClose is employed. And, as we continue to refine our technique and patient selection, we anticipate even greater success in achieving primary closure for fasciotomy sites otherwise requiring unsightly skin grating.