Efficacy of the shoelace technique for extremity fasciotomy wounds due to compartment syndrome.
Compartment syndrome
Extremity fasciotomy wound
Shoelace technique
Wound management
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
04 Sep 2023
04 Sep 2023
Historique:
received:
29
08
2022
accepted:
31
08
2023
medline:
6
9
2023
pubmed:
5
9
2023
entrez:
4
9
2023
Statut:
epublish
Résumé
The shoelace technique for compartment syndrome allows application of sustained tightening tension to an entire wound and intermittent tightening of the shoelace without requiring its replacement or anesthesia. We retrospectively evaluated the usefulness of the shoelace technique in the management of extremity fasciotomy wounds before and after its introduction in our institution. We targeted 25 patients who were diagnosed as having compartment syndrome and underwent extremity fasciotomy at our hospital from April 2012 to December 2021. The N group, comprising 12 patients treated without the shoelace technique, and the S group, comprising 13 patients treated with the shoelace technique, were compared retrospectively for each outcome. There were no significant differences between the two groups in patient background. Compared with the N group patients, all of the S group patients avoided skin grafting (S group: n = 0, 0%; N group: n = 6, 50.0%; p < 0.01). However, there was no significant difference in the number of days to final wound closure (S group: 39.5 [IQR 24.3-58.0] days; N group: 24.0 [IQR 18.5-31.0] days, p = 0.06). We considered the shoelace technique to be a useful wound closure method for fasciotomy wounds caused by compartment syndrome because it can significantly reduce the need for skin grafting and tends to shorten the wound closure period.
Sections du résumé
BACKGROUND
BACKGROUND
The shoelace technique for compartment syndrome allows application of sustained tightening tension to an entire wound and intermittent tightening of the shoelace without requiring its replacement or anesthesia. We retrospectively evaluated the usefulness of the shoelace technique in the management of extremity fasciotomy wounds before and after its introduction in our institution.
METHODS
METHODS
We targeted 25 patients who were diagnosed as having compartment syndrome and underwent extremity fasciotomy at our hospital from April 2012 to December 2021. The N group, comprising 12 patients treated without the shoelace technique, and the S group, comprising 13 patients treated with the shoelace technique, were compared retrospectively for each outcome.
RESULTS
RESULTS
There were no significant differences between the two groups in patient background. Compared with the N group patients, all of the S group patients avoided skin grafting (S group: n = 0, 0%; N group: n = 6, 50.0%; p < 0.01). However, there was no significant difference in the number of days to final wound closure (S group: 39.5 [IQR 24.3-58.0] days; N group: 24.0 [IQR 18.5-31.0] days, p = 0.06).
CONCLUSIONS
CONCLUSIONS
We considered the shoelace technique to be a useful wound closure method for fasciotomy wounds caused by compartment syndrome because it can significantly reduce the need for skin grafting and tends to shorten the wound closure period.
Identifiants
pubmed: 37667241
doi: 10.1186/s12891-023-06849-1
pii: 10.1186/s12891-023-06849-1
pmc: PMC10476399
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
704Informations de copyright
© 2023. BioMed Central Ltd., part of Springer Nature.
Références
Widgerow AD. Ischemia-reperfusion injury: influencing the microcirculatory and cellular environment. Ann Plast Surg. 2014;72(2):253–60.
doi: 10.1097/SAP.0b013e31825c089c
pubmed: 23241775
Fitzgerald AM, Gaston P, Wilson Y, Quaba A, McQueen MM. Long-term sequelae of fasciotomy wounds. Br J Plast Surg. 2000;53:690–3.
doi: 10.1054/bjps.2000.3444
pubmed: 11090326
Velmahos GC, Theodorou D, Demetriades D, Chan L, Berne TV, Asensio J, et al. Complications and nonclosure rates of fasciotomy for trauma and related risk factors. World J Surg. 1997;21:247–52 discussion 253.
doi: 10.1007/s002689900224
pubmed: 9015166
Williams AB, Luchette FA, Papaconstantinou HT, Lim E, Hurst JM, Johannigman JA, et al. The effect of early versus late fasciotomy in the management of extremity trauma. Surgery. 1997;122:861–6.
doi: 10.1016/S0039-6060(97)90099-4
pubmed: 9347868
Barnea Y, Gur E, Amir A, Leshem D, Zaretski A, Miller E, et al. Delayed primary closure of fasciotomy wounds with Wisebands, a skin- and soft tissue-stretch device. Injury. 2006;37:561–6.
doi: 10.1016/j.injury.2006.02.056
pubmed: 16643918
Harris I. Gradual closure of fasciotomy wounds using a vessel loop shoelace. Injury. 1993;24:565–6.
doi: 10.1016/0020-1383(93)90040-D
pubmed: 8244555
Zorrilla P, Marín A, Gómez LA, Salido JA. Shoelace technique for gradual closure of fasciotomy wounds. J Trauma. 2005;59:1515–7.
doi: 10.1097/01.ta.0000199242.24511.30
pubmed: 16394934
Govaert GA, van Helden S. Ty-raps in trauma: a novel closing technique of extremity fasciotomy wounds. J Trauma. 2010;69:972–5.
pubmed: 20938282
Kakagia D, Karadimas EJ, Drosos G, Ververidis A, Trypsiannis G, Verettas D. Wound closure of leg fasciotomy: comparison of vacuum-assisted closure versus shoelace technique. A randomised study Injury. 2014;45:890–3.
doi: 10.1016/j.injury.2012.02.002
pubmed: 22377275
Sheridan GW, Matsen FA 3rd. Fasciotomy in the treatment of the acute compartment syndrome. J Bone Joint Surg Am. 1976;58:112–5.
doi: 10.2106/00004623-197658010-00020
pubmed: 1249096
Johnson LS, Chaar M, Ball CG, Perez S, Nicholas JM, Wyrzykowski AD, et al. Management of extremity fasciotomy sites prospective randomized evaluation of two techniques. Am J Surg. 2018;216:736–9.
doi: 10.1016/j.amjsurg.2018.07.033
pubmed: 30064725
Eid A, Elsoufy M. Shoelace wound closure for the management of fracture-related fasciotomy wounds. ISRN Orthop. 2012;2012: 528382.
doi: 10.5402/2012/528382
pubmed: 24977081
pmcid: 4063194
Dodenhoff RM, Howell GE. The shoelace technique for wound closure in open fractures: report of early experience. Injury. 1997;28:593–5.
doi: 10.1016/S0020-1383(97)00095-8
pubmed: 9624335