A debridement and fasciotomy is a surgery performed to relieve pressure and swelling in a body compartment. Tissues surrounding the injury are cut open to release pressure and allow trapped fluids to escape.
A fasciotomy is commonly performed in the leg, but may also be performed in the hand, arm, abdomen, or foot. Once the patient is stable, a debridement gets rid of the necrotic and infected tissues.
A debridement and fasciotomy is also known as a limb-saving procedure and helps treat chronic compartment syndrome(Damage to the muscles and nerves due to pressure in a muscle compartment). The surgery has a high success rate and does not result in many side effects. The most common problem may be accidental damage to a nearby nerve.
How is a debridement + fasciotomy performed
Before surgery: Acute compartment syndrome requires immediate surgery to reduce damage and save the affected limb. If the condition is not severe, the doctor will examine the injury site thoroughly. The pressure in the limb will be measured to understand the extent of the compartment. The patient is required to disclose any medications or supplements he might be taking to the doctor before surgery. Get a second opinion on your limb issues from an expert at Yashoda Hospitals.
During surgery: A fasciotomy may be different depending on the body part and severity. The procedure is performed under regional or general anaesthesia. A skin-deep incision is made over the compartment area. The length of the incision covers the area of the limb between two joints. The fascia right below the skin is also cut in the same size. Dead tissue is removed surgically.
Loose stitches help cover the area and leave the wound open. Once the swelling subsides, the wound is closed and monitored regularly. Once the patient’s condition is stable, a debridement removes the necrotic and infected tissues. The procedure is repeated if required. Once all the necrotic tissues are removed, the wound is closed via suturing. Some cases may also require skin grafting. It may take up to two weeks for the wound to completely close.
After surgery:
The patient is taken to the recovery room and monitored for signs of infection or complication. Recovery may include:
- Pain medications
- Urine test to understand a breakdown of kidney function and muscle tissue
- Pushing IV fluids for hydration
Cost of a debridement + fasciotomy
| Description | Cost |
|---|---|
|
Average Cost of surgery in Hyderabad |
₹100,000-500,000 |
|
Average Cost of surgery in India |
₹100,000-500,000 |
| Surgery details | Description |
|---|---|
|
Number of days in the hospital |
Up to 3 days |
|
Type of surgery |
Major |
|
Type of Anaesthesia |
Local / General |
|
Number of days required to recover |
4-6 weeks |
|
Duration of the procedure |
30-60 minutes |
|
Type of surgical options available |
Open / Invasive |
Risks and complications of a debridement + fasciotomy
A delay in performing a debridement and fasciotomy can result in neurovascular complications and even amputation. There may be other complications such as the formation of scar tissue, thickening of the surgical scar, and loss of mobility in the affected joint. However, physical and occupational therapy can fix these issues.
Side effects are rare, but all surgeries carry risks. The potential risks of a debridement + fasciotomy include:
- Infection
- Excessive bleeding
- Chronic pain
- Scarring
- Future corrective surgeries, such as amputation
- Tissue damage causing loss of muscle or nerve function
- Breakdown of muscle tissue affecting kidney function
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Frequently Asked Questions about Debridement and Fasciotomy
A fasciotomy has the following risks: extended hospital stay, osteomyelitis, wound infection, scarring, surgeries for wound closure, skin grafting, scarring, slow-healing tissues, pain and nerve injury, chronic venous insufficiency, permanent muscle weakness, and cosmetic issues.
Patients experience pain, swelling, and reduced mobility in the affected limb after a fasciotomy. There will be a large wound in the area covered with light dressing, which can be uncomfortable.
It would help if one refrains from running or walking until the surgeon reviews the wound and gives the go-ahead. In most cases, walking may be introduced gradually 3-4 weeks after the surgery.
Fasciotomy wounds are often left open to allow self-healing. The patient will need to get the dressing changed regularly. The healing time usually lasts between 4 and 6 weeks.
Usually no. Muscles and fascia don’t heal and return to their original condition. Instead of returning to the previous smooth and flat texture, the muscle may heal into a tangled clump.
To reduce swelling after the fasciotomy, don’t cause friction on the tissue. Avoid swelling by limiting weight-bearing activities. The patient can also manage the swelling through rest, compression, elevating the limb, and applying ice.
Acute compartment syndrome usually doesn’t return after a fasciotomy surgery. However, in cases of chronic compartment syndrome, it may return after resuming an intense exercise regimen.
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