Nylon cable ties–assisted delay primary closure of fasciotomy wound in patients of forearm compartment syndrome

Abstract

Abstract Background Forearm compartment syndrome is a rare condition that requires forearm fasciotomy to release compartment pressure. In most cases, there is little to no skin damage initially, but after the fasciotomy, the skin flap may gradually retract. Traditional methods for reconstructing fasciotomy wounds, such as skin grafts or flaps, often result in an unpleasant appearance and require donor sites. Materials and Methods We present a method using nylon cable ties for delayed primary closure of forearm fasciotomy wounds. We retrospectively reviewed patients who underwent fasciotomy of forearms for compartment syndrome and nylon cable ties–assisted closure in a medical center from January 2017 to December 2022. Results Of the 7 eligible patients, 4 suffered from compartment syndrome of the forearm because of iatrogenic vascular rupture after procedures, whereas the other reasons included open-type fracture and fasciitis. For all the patients, nylon cable ties were applied for delayed primary wound closure after emergent fasciotomy. Six of them achieved successful wound closure by nylon cable ties without skin grafts or flaps on median day 12 (days 6–19). Only 1 patient required skin graft reconstruction after the application of nylon cable ties for 10 days. Conclusions Nylon cable ties, which are inexpensive and readily available, can be adjusted according to the different tension along the wound edges. They provide a simple, effective, and safe way to close difficult forearm fasciotomy wounds, which often result in a retracting skin flap after the procedure.