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首页> 外文期刊>Vascular and endovascular surgery >Contemporary Management and Outcome After Lower Extremity Fasciotomy in Non-Trauma-Related Vascular Surgery
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Contemporary Management and Outcome After Lower Extremity Fasciotomy in Non-Trauma-Related Vascular Surgery

机译：非创伤相关血管手术中下肢粘性术后的当代管理与结果

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Introduction: Acute compartment syndrome (ACS) is a challenging and recognized complication to vascular surgery revascularization. The aim of this study was to investigate the current epidemiology, management, and early outcomes of fasciotomy in vascular surgery. Methods: Retrospective cohort study of all patients undergoing lower extremity fasciotomy at a single university center between January 2008 and December 2014. Patient demographics, operative techniques, and outcomes were analyzed. Results: The cohort (n = 113 limbs; 107 patients; 48% women; mean age was 74 (12) years [range, 50-97 years]) included 81 (72%) limbs undergoing revascularization for acute limb ischemia, 7 (6.2%) limbs related to acute aortic disease, and 23 (20%) limbs undergoing elective vascular surgery. Five patients underwent bilateral lower extremity fasciotomy. In all, 64 (57%) limbs had signs of ACS and underwent a therapeutic fasciotomy, while 49 (43%) fasciotomies were prophylactic. There were 20 (18%) fasciotomies performed after endovascular interventions. A 4-compartment fasciotomy was performed in 82% (n = 93) of limbs with a double incision technique. Split thickness skin graft was required in 11% (12/112) and vacuum-assisted closure treatment in 11% (12/111). The mean length of stay in hospital was 11 (9) days. Most common complication was lower extremity nerve deficit 32% (33/104) followed by wound infection 30% (32/108). At 30-day follow-up, amputation rate was 13% (14/107 limbs) and mortality 23% (25/107 patients). In the multivariate logistic regression analysis, prophylactic fasciotomy was associated with amputation (odds ratio: 28.9; 95% confidence interval: 1.96-425; P = .014). Conclusion: Acute compartment syndrome is primarily related to acute ischemic conditions but occurs after both aortic or elective vascular procedures and endovascular treatments. There are significant complications related to lower extremity fasciotomy in vascular surgery.
机译：简介：急性室综合征（ACS）是对血管外科血运重建的挑战性和公认的并发症。本研究的目的是调查当前的流行病学，管理和血管手术中的粘性术的早期结果。方法：在2008年1月至2014年12月间在一所大学中心接受下肢诱人术患者的回顾性队列研究。分析了患者人口统计数据，手术技术和结果。结果：队列（n = 113四肢; 107名患者; 48％妇女;平均年龄为74（12）岁[范围，50-97岁]）包括81（72％）肢体接受急性肢体缺血的血运重建，7（ 6.2％）与急性主动脉疾病相关的四肢，23（20％）肢体接受选修血管手术。五名患者接受双侧下肢Fasciofy。总而言之，64（57％）肢体有ACS的迹象，并且经过治疗性诱饵，而49（43％）的诱导症是预防性的。在血管内干预后发生了20个（18％）的诱惑术。用双切口技术在82％（n = 93）肢中进行4室Fasciofy。在11％（12/112）中需要分裂厚度皮肤移植物，并在11％（12/111）中真空辅助闭合处理。医院的平均入住时间为11（9）天。最常见的并发症是下肢神经缺损32％（33/104），然后是伤口感染30％（32/108）。在30天的随访中，截肢率为13％（14/107四肢）和死亡率23％（25/107名患者）。在多变量逻辑回归分析中，预防性Fasciofy与截肢有关（差价率：28.9; 95％置信区间：1.96-425; P = .014）。结论：急性室综合征主要与急性​​缺血条件相关，但在主动脉或供应性血管手术和血管内治疗后发生。血管外科中的下肢粉丝术有显着的并发症。

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