Fasciotomy or fasciectomy is an emergency limb-saving surgical procedure wherein the fascia is cut open to relieve pressure or tension and swelling in a confined space or compartment of the body due to fluid accumulation. Fascia is a closed space of a multi-layered thick band or sheet of fibrous connective tissue, primarily collagen, that surrounds body parts in the form of some openings or compartments. Whenever there is swelling in the compartments, the fascia is pushed against the muscles, nerves, or blood vessels in the arms and legs, leading to a serious condition called compartment syndrome.
How is fasciotomy performed – Before, during, and after
Before surgery: The presence of compartment syndrome is confirmed through a complete medical history and a physical examination. Once the surgery is finalized, certain confirmatory tests are needed, including blood tests, urine tests, Chest X-ray, ECG, etc. In addition, certain medications that reduce airway secretions before and during surgery may be prescribed to keep the patient calm.
During surgery: The surgery is usually performed under general anesthesia, and the limb where the fasciotomy is planned is prepared and draped properly, and skin is incised to identify the underlying fascia, and an incision is made on the fascia to relieve the pressure. The wound is not sutured but only covered with dressing following fasciotomy.
After surgery: After recovery from the effect of anesthesia, the patient will be encouraged to move from the bed early to prevent deep vein thrombosis. The affected limb is kept elevated for 1-2 days after the surgery. Once the tissue swelling is reduced, focus shifts to wound care.
Cost of Fasciotomy
| Description |
Cost |
|
Average Cost of surgery in Hyderabad
|
₹ 1,50,00 – 2,50,000 |
|
Average Cost of surgery in India
|
₹ 1,00,000 – 5,00,000 |
| Surgery details |
Description |
|
Number of days in the hospital
|
3 to 5 days |
|
Type of surgery
|
Minor to Major
|
|
Type of Anaesthesia
|
General/ Regional
|
|
Number of days required to recover
|
Around 2-4 weeks |
|
Duration of the procedure
|
20 minutes to 3 hours (depending on severity) |
|
Type of surgical options available
|
Minimally invasive |
Risks and complications of fasciotomy
Incomplete or delayed fasciotomies lead to risk factors such as muscle necrosis with severe tissue leading to permanent damage to nerve or muscle function. Long-term risk factors of fasciotomy include chronic limb pain, altered sensation, edema, contracture, muscle herniation, dry skin, pruritus, skin discoloration, venous ulceration, etc. Other complications include extended hospital stay, wound infection and osteomyelitis, need for further surgery for delayed wound closure, delayed bone healing, chronic venous insufficiency, future corrective procedures including amputation, and some cosmetic problems.
