Comparison of lower extremity fasciotomy wound closure techniques in children: vacuum-assisted closure device versus temporary synthetic skin replacement
- 149 Downloads
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.
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.
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.
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.
KeywordsCompartment syndrome Lower extremity Child Fasciotomy V.A.C. device
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.
The authors hereby confirm that informed consent is given by all patients involved in this study.
- 8.Hug K, Hug-Schaumberg E, Bohr V. Hagendorf von Ditfurth D. EpiGARD. Synthetic skin replacement for temporary wound closure. 2015. http://consept-ag.com/wp-content/uploads/2015/09/Prospekt_Epigard_2015_NEU_low2.pdf. Accessed 6 Apr 2018.
- 10.KCI. Clinical guidlines. A reference source for clinicians. 2014. http://www.kci1.com/cs/Satellite?blobcol=urldata&blobheader=application%2Fpdf&blobkey=id&blobtable=MungoBlobs&blobwhere=1226689404554&ssbinary=true. Accessed 3 Jan 2017.