What is a Fasciotomy Procedure?

 To treat compartment syndrome, a surgeon will cut your fascia during a fasciotomy. The thin layer of connective tissue that envelops and supports your muscles is fascia.

A potentially deadly disease known as compartment syndrome arises when there is an increase in internal muscular pressure. Blood arteries that supply your muscles with blood may become compressed as a result of this pressure. People frequently feel excruciating pain and risk chronic muscular injury if it develops quickly.

A fasciotomy is a surgical procedure wherein the surrounding muscular tissue is sliced to release pressure.

Continue reading to find out more about fasciotomies, including the process and possible side effects.

What causes the need for a fasciotomy?

One treatment for compartment syndrome is fasciotomy. Your arms and legs include compartments, which are collections of blood vessels, muscles, and nerves. For instance, the muscles and tissues adjacent to your shin bone are located in the anterior compartment of your lower leg.

Although compartment syndrome can affect any compartment, the front of the lower leg is the most frequently affected. There are two subtypes within it:

• Acute compartment syndrome: This is when it appears out of the blue, frequently as a result of a severe injury. It's a medical emergency and typically very unpleasant.
• Chronic compartment syndrome: This is the stage during which it steadily develops, frequently as a result of sports. It normally gets better with rest and is not an emergency.

Compartment syndrome frequently appears following:

• a sudden impact injury
• surgery to repair a fracture
• an obstruction of a blood vessel induced by an artery clot or pressure
• prolonged immobility

By performing a fasciotomy, medical professionals can release internal pressure from your muscles and restore blood flow.

Fasciotomy complications and risks

Severe complications from compartment syndrome, such as amputation or even death, can be avoided with a fasciotomy. Like every surgery, there is a chance of problems. Complications from wounds might include:

• muscle herniation
• swelling
• recurrent ulcers
• the need for a skin graft
• scarring
• infections
• tendon problems
• discolored wounds
• itchy skin
• dry skin
• altered sensation around your wound

Individuals who need a fasciotomy run a significant risk of developing acute renal failure from muscle tissue death and rhabdomyolysis.

Additional issues consist of:

• delayed bone healing
• chronic pain
• a long hospital stay
• nerve damage
• chronic venous insufficiency

You may require a second operation if your first procedure is unsuccessful.

How effective is a fasciotomy for compartment syndrome?

Acute compartment syndrome can be a dangerous illness that can require an amputation or result in death. Timely fasciotomy delivery can help avert these issues.

The only proven cure for severe acute compartment syndrome is surgical fasciotomy.

Individuals who receive rapid treatment after a delayed fasciotomy have a three times higher fatality rate and twice higher risk of amputation.

Fasciotomy procedure

Below is a broad overview of what to anticipate before, during, and following a fasciotomy.

Before the procedure

A fasciotomy is frequently an emergency procedure carried out by a surgeon. If there is time, a surgical team at the hospital will give you a general anesthetic. During the process, general anesthesia renders you unconscious and can be injected intravenously (IV) or through a mask.

You might be given a localized anesthetic to block pain in the area of your body the surgeon is treating if general anesthesia cannot be administered in time.

During the procedure

A fasciotomy involves a surgeon cutting through your fascia to release pressure from the muscle. Here's an illustration of what could occur when pressure in a lower leg muscle is released:

1. Your lower leg will have one or more lengthy incisions made by your surgeon.
2. To reveal the underlying fascia, they will slice through adipose tissue.
3. To release the pressure, they will cut multiple lengthy incisions along each fascia compartment.
4. It's possible to leave your wounds open to stop pressure from growing up again. Days later, they might use stitches to close it. 

After the procedure

Following your treatment, you will awaken in a hospital recovery room. Before being released from the hospital, you'll probably have to have regular tests done to monitor your status and be hooked up to devices that measure your vitals.

Preparing for a fasciotomy

You won't have time to be ready if the fasciotomy is done by a surgeon on an emergency basis. A doctor will probably advise you to cease eating and drinking several hours in advance if it is planned. They might also advise you to cease taking blood-thinning drugs or supplements.

Fasciotomy recovery

The severity of your compartment syndrome and the speed at which you received treatment will determine how well you recover. Typically, wound closure happens five days to three weeks following your treatment.

According to a 2024 study, patients who underwent a fasciotomy for upper extremity acute compartment syndrome in fewer than six hours were in the hospital for an average of almost nine and a half days.

Your muscles and nerves may not entirely heal for several weeks or months.

Are there any alternatives to fasciotomy?

In cases where your illness is mild and chronic, you might not require a fasciotomy. Additional therapies consist of:

• physical therapy
• athletic taping
• injections of botulinum toxin
• biomechanical changes for athletes
• stopping aggravating activities

How much does a fasciotomy cost?

There are several variables that can affect the cost of a fasciotomy, including:

• whether you're having surgery in an emergency
• the body part treated
• where you live
• The surgery center or hospital that you go to

For reference, the charity FairHealth Consumer estimates that in Bismark, North Dakota, 80% of operations involving numerous incisions made in the thigh or knee to relieve pressure cost less than $2,429 without insurance. Potentially incurred extra expenses could be:

• $4,107 for surgery center
• $909 for anesthesia
• $5,969 for hospital outpatient

Takeaway

A fasciotomy is a compartment syndrome surgical procedure. In order to release pressure on your muscles, incisions must be made in your facia.

Life-threatening consequences may arise from acute compartment syndrome if treatment is not received. By having a fasciotomy, you can reduce the likelihood of serious side effects.