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Have You Ever Seen a Fasciotomy?

Fasciotomy or fasciectomy is the surgical cutting of the fascia to relieve the pressure. A fascia is a connective tissue that surrounds muscles, blood vessels, and nerves. The procedure is used to treat compartment syndrome. If pressure is not relieved within 12-24 hours, permanent nerve damage can occur and the limb will eventually be amputated.

Warning: The following images are graphic and may be disturbing to some readers (who are not nurses!).

Below are pictures of a patient who is undergoing Fasciotomy in his arm. All images belongs to GeneralBS of Reddit.

1. Starts with an Incision

The main purpose of a fasciotomy is to make the muscles swell and relieve the pressure within the compartment area. The patient is, of course, put into a regional anesthesia. Here the fascia is opened to ease the pressure. The muscle is exposed in a sterile environment covered usually by a sterile gauze. The exposure usually lasts 48 to 72 hours.

Fasciotomy

 2. Insertion of Surgical Strings

These rubber strings are inserted so that if the pressure is relieved, they can be carefully pulled together to gradually tighten and close the incision.

Fasciotomy Surgery - Stitching

 

Fasciotomy Surgery - Stitching

 

Fasciotomy Surgery - Stitching & Tightening the Opening

 3. Closing the Incision

Here, the incision is closed. If you compare it with the first picture above, you’ll see that the swelling and bulging was relieved.

Fasciotomy Surgery - Stitching & Completely Closing the Fascia

 4. Attachment with a Surgical Stapler

The skin layer of the incision is then connected using a surgical stapler and some stitches. Sometimes, when the fascia is not completely closed, the surgeon places a needed skin graft to close the wound.

Fasciotomy Surgery - Using Surgical Stapler to Close In the Skin

 

Images courtesy of GeneralBS

  • james andrew rosios

    whoah

  • rozu

    I couldn’t believe the incision could actually be that big! Scaary. I assisted a case of fasciotomy in o.r before, the patient had compartment syndrome because of a fatal electrical accident but the surgeon just made several shallow and small incisions.. :D D

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