[Indications and results of fasciotomy in vascular injuries of the lower extremities].

Aim of this study was to re-evaluate the indications for fasciotomy in war vascular injuries of the lower extremities. Retrospective and partially prospective analysis of 31 patients with surgical revascularisation performed during 1999 was done. Fasciotomy has been used as a prophylactic measure against development of Compartment Syndrome (CSy) in three out of ten patients within the first group where ischemia time was less than six hours before the time of repair. The second group, where ischemia time was longer than six hours before the time of repair, prophylactic fasciotomy (measured compartmental pressure lower than 30 mmHg) was performed in 8 patients. In 13 patients with already developed CSy fasciotomy was performed as the delayed treatment (measured compartmental pressure higher than 30 mmHg). Neither one of patients from the first group developed CSy. All patients who developed CSy had necrosis of neuromuscular tissues at the time of surgery. Musculectomy was required in five and limb amputation in six patients. The conclusion of this study is that when the ischemia time is less than six hours before the time of repair fasciotomy is not necessary. When the period from injury to the revascularisation is longer than six hours the prophylactic fasciotomy is recommended.