RESUMEN
OBJECTIVE: To assess the results of fasciotomy in patients with a chronic compartmental syndrome. DESIGN: Retrospective study. SETTING: Department of Surgery, Central Military Hospital, Utrecht, the Netherlands. METHOD: Closed fasciotomy was performed in 81 patients (151 compartments) after standardized measurement of the pressure of the symptomatic compartment during exercise. The anterior compartment was affected 149 times and the lateral compartment twice. The pressure reading was repeated at least 3 months after the operation. All operated patients 6 months postoperatively were sent a written questionnaire inquiring about the results of the operation. RESULTS: Postoperative complications included a neurinoma (3 times) and a seroma (once). The mean postoperative intramuscular pressures were lower than the preoperative ones: the pressure at rest fell from 22.1 to 14.0 mm Hg (p < 0.05), the exercise pressure from 57.5 to 25.4 mm Hg (p < 0.01) and the relaxation pressure from 34.4 to 25.2 mm Hg (p < 0.05). Ten patients had an unchanged increased pressure after the operation, for which a second fasciotomy was performed 4 times. Attenuation of symptoms was reported by 59 patients (76%). Nine patients with poor results had already had a combination with some other hyperpressure injury before the operation. CONCLUSION: Closed fasciotomy in a demonstrated chronic compartmental syndrome in most cases gave good results, viz. attenuation of symptoms and a decrease of the intramuscular pressure, especially after exercise.
Asunto(s)
Síndrome del Compartimento Anterior/cirugía , Fasciotomía , Adolescente , Adulto , Síndrome del Compartimento Anterior/fisiopatología , Enfermedad Crónica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/etiología , Presión , Recurrencia , Estudios Retrospectivos , Procedimientos Quirúrgicos Operativos/métodos , Resultado del TratamientoRESUMEN
The wish to prevent or improve scars, whether they are of surgical or traumatic origin, has led to the development of scar creams and gels that are said to influence the aesthetic appearance of a scar. In this article the literature on results of the topical application of various scar creams and gels is reviewed. It is concluded that no single modality has been proven to manage hypertrophic scarring except maybe silicone and BAPN. Further research into the physiology and pharmacophysiology of scar tissue is needed. With respect to scars, it still applies that even "plastic surgeons can't erase without a trace."