These ward staff, typically junior doctors, nursing, and health care assistants, have the most contact time with patients and are in the best position to detect increasing severity in symptoms. Įarly recognition of compartment syndrome is best detected by those professionals who have regular contact with the patients in the ward. These considerations of irreversible nerve and muscle damage and high risk of infection change the risk-benefit analysis in missed compartment syndrome and negate the necessity for emergency surgery. Patients who underwent a delayed fasciotomy had twice the amputation rate and three times the mortality. In a 2008 study, a cohort of 336 combat patients received 643 fasciotomies (upper and lower limb included). It did demonstrate the infection rate is significantly higher in patients whose fasciotomies were delayed. Ĭonversely, another more recent study has shown that there is no difference in limb salvage rate when comparing early (12 hours) fasciotomy. However, fasciotomies performed after 12 hours resulted in only 8% regaining normal limb function. One study has demonstrated that fasciotomies performed within 6 hours resulted in almost complete limb function recovery, between 6 and 12 hours normal functional recovery rate was 68%. The primary relative contraindication to performing a fasciotomy is delayed presentation if the clinician suspects compartment syndrome of having been present for more than 12 hours, there is a potential risk of reperfusion injury. Every decision to perform an emergency fasciotomy should be made by a senior team member and on a case-by-case basis in the context of the patient and the injury sustained. This section will explore the relative contraindications. There is no absolute contraindication to performing a fasciotomy.
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