Fasciotomy
Surgical cutting of fascia to relieve compartment syndrome pressure
Definition
A fasciotomy is the emergency surgical incision of fascia to relieve pressure in compartment syndrome, a limb-threatening condition where swelling within a muscle compartment compromises circulation.
Compartment Syndrome Signs (6 P's)
- Pain out of proportion to injury, worsened by passive stretch
- Pallor (late)
- Paresthesia
- Paralysis (late)
- Pulselessness (late)
- Poikilothermia (coolness)
Common Precipitants
Fracture (especially tibia and forearm), crush injuries, prolonged tourniquet use, burns, snake bite, IV infiltration, tight casts or dressings.
Nursing Priority
Immediate identification is critical. Irreversible muscle and nerve damage occurs within 6 to 8 hours. LOOSEN any constrictive casts/dressings, elevate NO HIGHER than the heart (elevation further reduces perfusion), notify surgeon immediately. Post-fasciotomy: wound left open initially, delayed primary closure or skin graft. Monitor for infection, neurovascular status.
NCLEX Relevance
Priority: early recognition. Do NOT elevate above heart level.