General, Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisia 1, 56100, Pisa, Italy.
General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy.
World J Emerg Surg. 2020 Oct 21;15(1):60. doi: 10.1186/s13017-020-00339-8.
Compartment syndrome can occur in many body regions and may range from homeostasis asymptomatic alterations to severe, life-threatening conditions. Surgical intervention to decompress affected organs or area of the body is often the only effective treatment, although evidences to assess the best timing of intervention are lacking. Present paper systematically reviewed the literature stratifying timings according to the compartmental syndromes which may beneficiate from immediate, early, delayed, or prophylactic surgical decompression. Timing of decompression have been stratified into four categories: (1) immediate decompression for those compartmental syndromes whose missed therapy would rapidly lead to patient death or extreme disability, (2) early decompression with the time burden of 3-12 h and in any case before clinical signs of irreversible deterioration, (3) delayed decompression identified with decompression performed after 12 h or after signs of clinical deterioration has occurred, and (4) prophylactic decompression in those situations where high incidence of compartment syndrome is expected after a specific causative event.
筋膜室综合征可发生于身体的许多部位,其严重程度不一,从无症状的内环境改变到危及生命的严重情况都有。外科减压干预通常是治疗的唯一有效方法,尽管缺乏评估干预最佳时机的证据。本文系统地回顾了文献,根据可能需要立即、早期、延迟或预防性手术减压的筋膜室综合征进行了分类。减压时机分为以下 4 类:(1)对于那些错过治疗会迅速导致患者死亡或极度残疾的筋膜室综合征,需要立即减压;(2)早期减压,时间负担为 3-12 小时,且无论如何都要在临床恶化的不可逆迹象出现之前进行;(3)延迟减压是指在 12 小时后或出现临床恶化迹象后进行减压;(4)预防性减压适用于在特定致病事件后预计会发生高发病率的筋膜室综合征的情况。