Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
12
pubmed:dateCreated
2005-1-24
pubmed:abstractText
The purpose of this study was to review recent experience with upper extremity fasciotomy. This study is a retrospective review of injured patients undergoing fasciotomy in the upper extremity at an urban trauma center. Mechanisms of injury, indications for and timing of fasciotomy, role of compartment pressures, techniques of closure, amputation rate, and patient outcomes were collected. Over a 3-year period, 201 fasciotomies were performed in the extremities of 157 injured patients, including 37 in the upper extremities of 27 patients. The mechanisms of injury were penetrating trauma in 13 patients (10 GSW, three SW), blunt or crush in 9, and burns (4 electric, 1 flame) in 5. Vascular injuries and fractures were present in 15 (56%) and 9 (33%) patients, respectively. The decision to perform a fasciotomy was a clinical one in 21 patients (75%), and only 6 patients had compartment pressures measured (range, 40-87 mm Hg; mean, 52). Upper extremity fasciotomy was performed at a first operation in 24 patients, whereas only 3 patients had a delayed fasciotomy from 6 to 48 hours after injury. Two patients died on the first hospital day, and 5 others had an amputation of an upper extremity at a mean of 8 days (range 2 to 26) after injury; however, no amputation was due to the failure to perform a timely fasciotomy. In the remaining 20 patients, closure of the fasciotomy site was performed at a mean of 9 days (range, 2 to 22) after injury, most commonly by split thickness skin grafting. Hospital stay was a mean of 20 days (range, 7-35). We conclude that 1) upper extremity fasciotomy accounts for less than 20 per cent of all fasciotomies performed; 2) a clinical decision is the most common reason for performing upper extremity fasciotomy, and only 11 per cent of patients underwent a delayed fasciotomy in this review; 3) the need for upper extremity fasciotomy is associated with a length of stay longer than expected for overall injury severity.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Dec
pubmed:issn
0003-1348
pubmed:author
pubmed:issnType
Print
pubmed:volume
70
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1088-93
pubmed:meshHeading
pubmed:year
2004
pubmed:articleTitle
A review of upper extremity fasciotomies in a level I trauma center.
pubmed:affiliation
Department of Surgery, Grady Memorial Hospital, Atlanta, Georgia, USA.
pubmed:publicationType
Journal Article