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European Journal of Trauma and Emergency Surgery

, Volume 45, Issue 5, pp 809–814 | Cite as

Comparison of lower extremity fasciotomy wound closure techniques in children: vacuum-assisted closure device versus temporary synthetic skin replacement

  • Hannah Rachel BussellEmail author
  • Christoph Alexander Aufdenblatten
  • Corina Gruenenfelder
  • Stefan Altermatt
  • Sasha Job Tharakan
Original Article

Abstract

Purpose

No clear consensus on the optimal treatment of fasciotomy wounds due to acute compartment syndrome of the lower leg in children exists. We therefore compared two commonly used methods to close fasciotomy wounds, Epigard, a temporary synthetic skin replacement (SSR) and the vacuum-assisted closure (V.A.C.) device, in respect of treatment duration and complication rates.

Methods

We studied the cases of 27 patients who were treated at our institution for acute compartment syndrome of the lower leg with a fasciotomy over a 10-year period. The fasciotomy wound was either treated with SSR or V.A.C. device. We recorded the number of procedures to definitive wound closure, days to wound closure, hospitalization days and sequelae rate.

Results

In the V.A.C. device group (18 patients) the mean number of procedures until definitive wound closure was 3.1, mean days until wound closure was 9.4 and mean days of hospitalization was 16.2. One patient suffered from a wound infection and one patient required a full thickness skin graft. In the SSR group (9 patients), the mean number of procedures was 1.8, mean days until definitive wound closure was 4.9 and mean days of hospitalization was 9.9. No sequelae were recorded. There was a statistically significant smaller number of procedures (p value 0.018), fewer days to definitive wound closure (p value 0.002) and fewer hospitalization days (p value 0.005) in the SSR group.

Conclusions

Both SSR and V.A.C. device are safe and reliable for closure of fasciotomy wounds in children, whereas SSR seems to lead to shorter time until definitive wound closure.

Keywords

Compartment syndrome Lower extremity Child Fasciotomy V.A.C. device 

Notes

Funding

The authors hereby confirm that no funding was received for this project.

Compliance with ethical standards

Conflict of interest

Hannah Rachel Bussell, Christoph Alexander Aufdenblatten, Corina Gruenenfelder, Stefan Altermatt and Sasha Job Tharakan hereby confirm that no conflicts of interest exist.

Informed consent

The authors hereby confirm that informed consent is given by all patients involved in this study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Pediatric SurgeryUniversity Children’s Hospital ZurichZurichSwitzerland
  2. 2.ZurichSwitzerland

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