Complications and nonclosure rates of fasciotomy for trauma and related risk factors

G. C. Velmahos, D. Theodorou, D. Demetriades, L. Chan, T. V. Berne, Juan A. Asensio, E. E. Cornwell, H. Beizberg, B. M. Stewart

Research output: Contribution to journalArticle

51 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)247-253
Number of pages7
JournalWorld Journal of Surgery
Volume21
Issue number3
DOIs
StatePublished - 1997
Externally publishedYes

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Wounds and Injuries
Lower Extremity
Vascular System Injuries
Upper Extremity
Blood Vessels
County Hospitals
Skin
Skin Transplantation
Fasciotomy
Trauma Centers
Teaching Hospitals
Therapeutics

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Velmahos, G. C., Theodorou, D., Demetriades, D., Chan, L., Berne, T. V., Asensio, J. A., ... Stewart, B. M. (1997). Complications and nonclosure rates of fasciotomy for trauma and related risk factors. World Journal of Surgery, 21(3), 247-253. https://doi.org/10.1007/s002689900224

Complications and nonclosure rates of fasciotomy for trauma and related risk factors. / Velmahos, G. C.; Theodorou, D.; Demetriades, D.; Chan, L.; Berne, T. V.; Asensio, Juan A.; Cornwell, E. E.; Beizberg, H.; Stewart, B. M.

In: World Journal of Surgery, Vol. 21, No. 3, 1997, p. 247-253.

Research output: Contribution to journalArticle

Velmahos, GC, Theodorou, D, Demetriades, D, Chan, L, Berne, TV, Asensio, JA, Cornwell, EE, Beizberg, H & Stewart, BM 1997, 'Complications and nonclosure rates of fasciotomy for trauma and related risk factors', World Journal of Surgery, vol. 21, no. 3, pp. 247-253. https://doi.org/10.1007/s002689900224
Velmahos, G. C. ; Theodorou, D. ; Demetriades, D. ; Chan, L. ; Berne, T. V. ; Asensio, Juan A. ; Cornwell, E. E. ; Beizberg, H. ; Stewart, B. M. / Complications and nonclosure rates of fasciotomy for trauma and related risk factors. In: World Journal of Surgery. 1997 ; Vol. 21, No. 3. pp. 247-253.
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