Fasciotomy of the Lower Extremity
Vascular surgery procedures, such as bypasses or endovascular interventions, often restore blood flow to tissues acutely deprived of oxygen. Once blood flow is restored, these tissues can swell with edema. The edema is contained by the surrounding fascia, a nonelastic enveloping tissue. The fascia prevents adequate swelling of the muscles like a corset. This is called compartment syndrome. As a result, the muscles compress veins and arteries preventing blood from getting into the extremity and returning to the heart. This lack of blood flow results in initial, reversible nerve and tissue damage. If the fascia is not opened the damagebecomes irreversible and can result in limb loss. Recognition of compartment syndrome and swift and adequate treatment with a fasciotomy are necessary to prevent amputation and maximize limb function.
Patients that require a fasciotomy may have sustained a trauma, such as a crush injury, and subsequent revascularization. Alternatively, they may have had an acute loss of blood flow that was restored. Pain in the calf is often the first symptom, especially pain that occurs with passive motion. This can be accompanied by numbness or a pins and needles sensation. A very late finding is a lack of pulses. Often there is severe tissue loss by the time pulses are lost. However, regardless when the compartment syndrome is diagnosed, a fasciotomy is absolutely necessary. A fasciotomy of the lower extremityinvolves incisions on both sides of the lower extremity and opening all four compartments. This allows the muscles to swell and restores blood flow, relieving symptoms. These incisions can be closed once the edema resolves. Alternatively, skin grafts may be required if the skin is too tight to close. Occasionally, patients may have transient compartment syndrome symptoms after exercise. While not usually emergent, these patients may require excision of part of the fascia to prevent future symptoms.
Any surgical procedure has risks and the outcome of a surgical procedure depends on the overall health of the patient and the severity of disease. When patients are looking for a surgeon to perform a fasciotomy of the lower extremity, they should find a high-caliber vascular surgeon. For patients seeking the services of a first-rateBradenton vascular surgeon, look no further than Dr. Jenna Kazil with the Florida Surgical Clinic located in Bradenton, FL. Dr. Kazil is a surgical specialist considered by many asa five-starvascular surgeon in Bradenton. As a surgical specialist located on the West coast of Florida she has developed the experience necessary to perform a wide variety of surgical procedures. Contact Dr. Kazil for any vascular and surgical needs.