Fasciotomy in the treatment of acute lower extremity ischemia due to trauma, vascular wounds at Viet Duc University Hospital

Abstract

Objective: The predominant groups of fasciotomy in the treatment of acute lower extremity ischemia due to trauma, vascular wounds at Viet Duc University Hospital. Methods: A retrospective, descriptive, non-control study on patients with a diagnosis of acute lower extremity ischemia who underwent revascularization with leg fasciotomy at Viet Duc University Hospital in the period from January 2020 to December 2021. Results: In 70 studied patients, the male/female ratio = 1.8/1; mean age was 33.2 ± 13.2 years old. Vessels damaged by trauma accounted for 94.3%, wounds accounted for 5.7%; mainly popliteal artery accounted for 88.6%. 75.7% of patients had associated lower extremity fractures or dislocations. Rutherford acute limb ischemia grade IIa or higher accounts for 95.7%. 100% of patients were revascularized at >6 hours from the time of the accident. All patients were able to open the leg fascia right at the beginning; 74.3% performed by a team of orthopedic surgeons; 98.6% of leg fasciotomies were 2 incisions for 4 compartments. The average time of fasciotomy’s closure was 13.84 ± 6.445 days, the earliest was 4 days, the latest was 31 days. After 1 month of discharge, 82.4% of patients limited movement of the limbs; 48.5% of patients did not feel pain in the extremities after surgery. After 6 months, 33.8% of the patients had limited limb movement, 97.1% did not feel pain in the extremities. Conclusion: Leg fasciotomy in the treatment of acute lower extremity ischemia due to trauma or injury is performed, in which, the duration of limb ischemia > 6 hours, popliteal artery injury and the acute limb ischemia classification according to Rutherford from IIa are the predominant groups.