Shoe lace technique, a simple and less expensive method for Fasciotomy wound closure following compartment syndrome

Abstract

Introduction: Compartment syndrome is a common and severe medical condition that can lead to ischemia and ultimately tissue loss. The treatment of choice is emergent fasciotomy to lower the compartment pressure. However, closing fasciotomy wound often presents a problem because of edema and skin retraction. As a result, numerous techniques have been devised to optimize wound closure. AIM: To perform fasciotomy wound closure by shoe lace technique which is a type of dermal apposition technique for gradual primary closure of fasciotomy wound. Materials and Methods: The study included 19 patients who presented with compartment syndrome involving either upper or lower extremities due to various causes. Decompression fasciotomy was performed in all the cases to relieve compartment pressure. Shoe lace technique was performed for closure of wound. Patients demographics, location of fasciotomy, time duration between injury and fasciotomy, number of tightening session, time to primary closure, length of hospital stay, need for skin grafts and any complication if occurred during procedure were recorded. Results: Out of 19 patients 15 were males and 4 were females. Average age was 34.8 years. Lower extremity was involved in 14 cases. Fracture was the cause of compartment syndrome in 16 cases. Closure was obtained at an average of 3.5 tightening session. All the fasciotomy wounds were closed within an average of 8.3 days. Average duration of hospital stay was 12.3 days. No major complication was encountered in the study one case reported to have infection at wound site. Conclusion: Shoe lace technique is a simple and economical method for fasciotomy wound closure. It takes less time to closure, does not need a second procedure for closure thus reduces need of nursing care, hospital stay resulting in lower morbidity, healthcare cost and better aesthetic result.