Dekker Paige K, Chang Brian L, Fleury Christopher M, Evans Karen K
Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, D.C.
Plast Reconstr Surg Glob Open. 2021 Apr 8;9(4):e3530. doi: 10.1097/GOX.0000000000003530. eCollection 2021 Apr.
Achieving primary closure of lower extremity fasciotomy wounds is difficult. Surgeons are faced with the option of waiting potentially long periods of time for edema to reside, in order to attempt delayed primary closure (DPC) versus closing at an earlier time with a split thickness skin graft. DPC offers superior aesthetic outcomes than split thickness skin grafts but traditionally cannot occur until later in the clinical course once excessive edema has subsided. We present a case of a young athlete with compartment syndrome, which was managed with an alternative technique for achieving DPC: serial partial closure under tension with retention sutures and negative pressure wound therapy. The successful outcome in this single case should prompt further studies investigating the objective benefits of this novel method to achieve DPC following fasciotomy.
实现下肢筋膜切开术伤口的一期闭合很困难。外科医生面临着这样的选择：等待可能很长时间让水肿消退，以便尝试延迟一期闭合（DPC），还是尽早用分层皮片移植进行闭合。与分层皮片移植相比，DPC能提供更好的美学效果，但传统上要等到临床病程后期，过度水肿消退后才能进行。我们报告一例年轻运动员发生骨筋膜室综合征的病例，采用了一种实现DPC的替代技术进行治疗：通过张力下连续部分闭合加保留缝线和负压伤口治疗。这一单例的成功结果应促使进一步研究，探讨这种实现筋膜切开术后DPC的新方法的客观益处。
