Classification of Fracture
Proper management of all fractures and dislocations—regardless of location, extent, or severity—is based on three criteria: the integrity of the overlying skin and soft tissues (i.e., open or closed fracture),…
Healing of Excised Skin Wound
Fibroblasts begin to proliferate in the base of the wound. The fibroblastic proliferation is followed immediately by the development of new capillaries bringing nutrients and oxygen to the newly formed…
Healing of Incised, Sutured Skin Wound
The first step in the inflammatory phase is the formation of a blood clot, which controls bleeding and forms a thin fibrin network, bridging the wound margins. Simultaneously, an intense…
Incisions for Compartment Syndrome of Leg
After the four-compartment fasciotomy, intraoperative monitoring of compartmental pressure should be performed to document the decompression. Very little muscle should be debrided at the time of initial decompression, because it…
Incisions for Compartment Syndrome of Forearm and Hand
Postoperative care of the forearm includes a bulky dressing and splinting. The dressing is changed in 3 to 4 days in the operating room. Split-thickness skin grafts are almost always…
Measurement of Intracompartmental Pressure
DECOMPRESSION OF COMPARTMENT SYNDROME There are no satisfactory nonsurgical methods for treating compartment syndromes; however, cooling of the tissue may prolong tolerance to ischemia and proper hydration may help avoid…
Acute Anterior Compartment Syndrome
Pulses Present and Pink Color. Unless there is a major arterial injury or disease, peripheral pulses are palpable and capillary refill is routinely present. Although compartment pressures are occasionally high…
Pathophysiology of Compartment and Crush Syndromes
Thermal injuries (burns), in addition to decreasing compartment space, are associated with massive edema. Measurement of intramuscular pressure is needed to document the underlying compartment tamponade and the need for…
Etiology of Compartment Syndrome
If multiple compartments are involved and a significant amount of muscle infarction is present, the patient may develop crush syndrome, which refers to the systemic effects of myonecrosis on the…
Excision and Grafting for Burns
Deep, unequivocally full-thickness burns may be excised to the level of the investing fascia using a scalpel, an electrocautery device, or even a laser. The excised wound must be covered…
