Liu Jun, Liu Zhi Hui, Lu Ruo Nan
Burns Department of Gansu Provincial Hospital, Lanzhou, China.
Hospital of Chongqing Medical University, Chongqing, China.
Injury. 2025 Feb;56(2):112069. doi: 10.1016/j.injury.2024.112069. Epub 2024 Dec 4.
One of the primary causes of heat-induced compartment syndrome is the loss of elasticity of the body surface eschar itself, we have recently replaced escharotomy with conservative tangential excision in the treatment of compartment syndrome caused by heat and achieved good results.
Since 2019, our burn center has applied conservative tangential excision and heterogeneous dermal coverage technology for decompression treatment of 16 patients with thermal-induced compartment syndrome, involving 19 parts of the limbs and 5 parts of the chest and abdomen. All cases were treated with decompression under general anesthesia within 12-48 h after burn.
All patients were treated with conservative tangential excision for decompression. After limb decompression, the peripheral blood supply was restored, and the obvious pulse could be touched. No further fasciotomy was performed, and no secondary damage of deep muscle, nerve and vascular tissue was found in the follow-up treatment; After thoracic and abdominal decompression, there was no respiratory restriction and circulatory disorder.
Conservative tangential excision represents an effective method for both the prevention and treatment of heat-induced compartment syndrome, it can be used as an alternative method for escharotomy.
体表焦痂本身弹性丧失是热致筋膜间隔综合征的主要原因之一，我们最近在热致筋膜间隔综合征的治疗中用保守削痂术取代了焦痂切开术，并取得了良好效果。
自2019年以来，我们烧伤中心应用保守削痂术及异体真皮覆盖技术对16例热致筋膜间隔综合征患者进行减压治疗，累及四肢19处、胸腹部5处。所有病例均在烧伤后12 - 48小时内于全身麻醉下进行减压治疗。
所有患者均采用保守削痂术进行减压。肢体减压后，外周血供恢复，可触及明显脉搏。未进一步行筋膜切开术，随访治疗中未发现深部肌肉、神经及血管组织的继发性损伤；胸腹部减压后，无呼吸受限及循环障碍。
保守削痂术是预防和治疗热致筋膜间隔综合征的有效方法，可作为焦痂切开术的替代方法。
