Search: id:"swepub:oai:lup.lub.lu.se:d5c109bb-b97f-4c5a-b040-4940f3fac344" >
Prophylactic and Th...
Prophylactic and Therapeutic Fasciotomy for Acute Compartment Syndrome after Revascularization for Acute Lower Limb Ischemia—Renal and Wound Outcomes
-
- Karonen, Emil (author)
- Lund University,Lunds universitet,Vaskulära sjukdomar - kliniska studier,Forskargrupper vid Lunds universitet,Vascular Diseases - Clinical Research,Lund University Research Groups,Skåne University Hospital
-
- Eek, Frida (author)
- Lund University,Lunds universitet,Människan i rörelse: hälsa och rehabilitering,Forskargrupper vid Lunds universitet,Human Movement: health and rehabilitation,Lund University Research Groups
-
- Butt, Talha (author)
- Lund University,Lunds universitet,Vaskulära sjukdomar - kliniska studier,Forskargrupper vid Lunds universitet,Vascular Diseases - Clinical Research,Lund University Research Groups,Skåne University Hospital
-
show more...
-
- Acosta, Stefan (author)
- Lund University,Lunds universitet,Vaskulära sjukdomar - kliniska studier,Forskargrupper vid Lunds universitet,Vascular Diseases - Clinical Research,Lund University Research Groups,Skåne University Hospital
-
show less...
-
(creator_code:org_t)
- Elsevier BV, 2023
- 2023
- English 10 s.
-
In: Annals of Vascular Surgery. - : Elsevier BV. - 0890-5096. ; 88, s. 154-163
- Related links:
-
http://dx.doi.org/10... (free)
-
show more...
-
https://lup.lub.lu.s...
-
https://doi.org/10.1...
-
show less...
Abstract
Subject headings
Close
- Background: Acute Compartment Syndrome (ACS) is a significant complication after revascularization for acute lower limb ischemia (ALI). High risk patients sometimes undergo prophylactic fasciotomy (PF) to prevent ACS. Patients that develop ACS undergo therapeutic fasciotomy (TF). The optimal timing of fasciotomy has been debated. The aim of this study was to describe and compare renal and wound outcomes in patients undergoing PF and TF. Methods: A retrospective cohort study including 76 patients undergoing PF (n = 40) or TF (n = 36) after revascularization for ALI between 2006 and 2018. Estimated glomerular filtration rate (e-GFR) was used to evaluate renal function and compare within (paired-samples t-test) and between (analysis of variance) groups. Wound complications and healing time were compiled from the complete wound healing period and compared between groups with Pearson's chi-squared-and log-rank test, respectively. Results: E-GFR improved over the in-hospital period with 8.2 ml/min/1.73 m2 (95% confidence interval [CI] 2.4–14.1, P = 0.007) in the PF group and 4.4 ml/min/1.73 m2 (95% CI 1.2–7.7, P = 0.010) in the TF group, with no significant difference between the 2 groups (0.3 ml/min/1.73 m2, 95% CI −6.7 to 7.4, P = 0.93). The wound infection rate was higher after TF (PF = 60.6 % and TF = 82.4 %, P = 0.048), whereas rate of other wound complications (PF = 61.3 % and TF = 35.3%, P = 0.036) was higher after PF. Conclusions: Overall wound complications were high, whereas renal function improved during in-hospital stay. A more conservative approach to fasciotomy could avoid unnecessary fasciotomies and reduce wound complications, while holding the potential to sufficiently preserve renal function if fasciotomy is needed for ACS. This would be possible and safe if an early diagnosis and treatment of ACS can be ensured.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Publication and Content Type
- art (subject category)
- ref (subject category)
Find in a library
To the university's database