Chronic (Exertional) Compartment Syndrome The incision is repaired later when swelling subsides. Sometimes, the swelling is severe enough that the skin incision cannot be closed immediately. Your doctor will make an incision and cut open the skin and fascia covering the affected compartment. There is no effective nonsurgical treatment. SymptomsĪcute compartment syndrome is a surgical emergency. This is usually relieved by discontinuing the exercise, and is usually not dangerous. People who participate in activities with repetitive motions, such as running or marching, are more likely to develop chronic compartment syndrome. The pain and swelling of chronic compartment syndrome is caused by exercise. If you have a cast, contact your doctor immediately.Ĭhronic (Exertional) Compartment Syndrome If symptoms of compartment syndrome develop, remove or loosen any constricting bandages. Casts and tight bandages may lead to compartment syndrome. Taking steroids is a possible factor in compartment syndrome. This can happen after severe intoxication with alcohol or other drugs. The development of compartment syndrome in this manner usually occurs in people whose brain function is impaired. Most healthy people will naturally move when blood flow to a limb is blocked during sleep. Lying for too long in a position that blocks a blood vessel, then moving or waking up can cause this condition. A blood vessel can also be blocked during sleep. This may occur after a surgeon repairs a damaged blood vessel that has been blocked for several hours. Reestablished blood flow after blocked circulation.It can also happen after overly vigorous exercise that causes muscle tissue to break down (rhabdomyolysis) This type of injury can occur when a motorcycle falls on the leg of the rider, or a football player is hit in the leg by another player's helmet. Rarely, it develops after a relatively minor injury.Ĭonditions that may bring on acute compartment syndrome include: This can help reduce the size of the defect to be covered.Acute compartment syndrome usually develops after a severe injury, such as a car accident or a broken bone. Careful use of elastic retention sutures (elastic vessel loop woven through skin staples) can help counteract skin contraction, and be tightened progressively as swelling resolves. This is only permissible if it can be achieved without any skin tension it is inadvisable in smokers, who have impaired capacity for soft-tissue healing.įasciotomy wound edges tend to retract and become difficult to close. It is tempting to the surgeon to try early secondary skin suture, rather than skin-graft coverage, once the swelling has subsided. The simplest and safest technique is to cover the healthy soft-tissue defect with a split skin graft: at a later date, when the limb contours have returned to normal, the grafted area can be excised and secondary skin closure performed without tension. Once any skeletal injury is under control, the fasciotomy wound(s) healthy and the swelling of the soft tissues has sufficiently regressed, consideration must be given to achieving skin coverage. Reperfusion injury is another cause of compartment syndrome. After blood flow is restored, capillaries leak and ischemic muscle swells. An arterial injury may cause compartmental tissue ischemia.Muscle tolerates short periods of hypoxia, but after a few hours, progressive necrosis begins.(MPP has also been called "Delta P", to indicate the difference between diastolic blood pressure and intramuscular pressure.) This difference in pressure reflects tissue perfusion far more reliably than the absolute intramuscular pressure.
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