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Fasciotomy

AMBULATORY CARE:

What you need to know about a fasciotomy:

A fasciotomy is surgery to relieve pressure that is cutting off blood flow and nerve signals to muscles and tissues. Pressure builds under tissue called fascia that covers muscles and organs. The pressure may be caused by a crush injury, necrotizing fasciitis, or compartment syndrome. During a fasciotomy, an incision is made in the fascia. This helps relieve the pressure. A fasciotomy can be done on most areas of the body, but it is most common on the arm or leg.

How to prepare for a fasciotomy:

  • Fasciotomy is often done as emergency surgery because pressure builds up suddenly. This means you might not have time to prepare. If you can prepare, your surgeon will tell you what to do. The surgeon may tell you not to eat or drink anything before midnight on the day of surgery. You will be told which medicines to take or not take on the day of surgery. Tell your surgeon if you have ever had problems with anesthesia. Arrange to have someone drive you home after surgery and stay with you for 24 hours.
  • You may be given antibiotics to prevent a bacterial infection. Tell your surgeon if you have ever had an allergic reaction to an antibiotic.

What will happen during a fasciotomy:

  • You may be given general anesthesia to keep you asleep and free from pain during surgery. You may instead be given regional anesthesia to numb the surgery area. You will be awake with regional anesthesia, but you should not feel pain. Your surgeon will make one or more incisions in the skin and fascia. This will relieve pressure that has built up in the area.
  • Your surgeon may leave the area open to let the pressure go down. This can take several days. A skin graft may be placed over the incision to protect the area until the pressure goes down. A skin graft is a piece of skin taken from another body area.

What will happen after a fasciotomy:

  • Negative pressure wound therapy may be used before the incision is closed. A machine helps bring the edges of your skin closer together. Bacteria can also be removed with the machine.
  • After the pressure goes down, the incision will be closed with stitches or staples. Strips of medical tape may be used to keep the edges of your skin together.
  • The area may be wrapped with a compression bandage. You will be shown how to wrap the bandage to make sure it is not too tight. You should be able to fit 2 fingers between the bandage and your skin. You may need to remove and rewrap the area regularly. Your healthcare provider will tell you how often to do this.

Risks of a fasciotomy:

Nerves may be damaged or destroyed near the surgery site. You may develop necrosis (tissue death). You will need more surgery to remove the tissue if this happens.

Seek care immediately if:

  • Your stitches or staples come apart.
  • You have bleeding from the surgery area that does not stop after 10 minutes of firm pressure.
  • You cannot move the arm or leg that had the fasciotomy.
  • You have signs of infection in the surgery area, such as red streaks, pus, or a foul odor.
  • You have new or increased swelling in the surgery area.

Contact your healthcare provider if:

  • You have a fever.
  • You have new or worsening pain in the surgery area.
  • You have questions or concerns about your condition or care.

Medicines:

You may need any of the following:

  • Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
  • Antibiotics help fight or treat a bacterial infection.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Wound care:

Look for signs of infection every time you care for your wound. Signs include red streaks, pus, and a foul-smelling discharge.

  • Wash your hands before and after you take care of your wound.
  • Keep the bandage clean and dry. Do not stop using the bandage on your wound unless your healthcare provider says it is okay.
  • Clean the wound and change the dressing as often as directed by your healthcare provider.
  • If you have strips of medical tape across the incision area, do not peel them off. They will fall off on their own in about 7 to 10 days. You can trim the edges as they start to peel to keep them from tearing.
  • Apply firm, steady pressure to your wound if it bleeds. Use a clean towel or gauze.

Self-care:

  • Rest as needed. Rest can help you heal and prevent you from causing more damage to the surgery area. Try to rest often during the day. You may need to wait up to 3 weeks before you can drive or return to your normal activities. The time will depend on why you had the fasciotomy and where on your body it was done. Your healthcare provider will tell you when you can start driving again, and when to return to normal activities.
  • Elevate the area, if possible. If you had a fasciotomy in an arm or leg, raise the area above the level of your heart as often as possible. Prop the area on pillows to keep it elevated comfortably. Elevation helps decrease swelling.
  • Apply ice to the area as directed. Ice helps relieve pain and swelling, and may help prevent tissue damage. Use an ice pack, or put crushed ice in a plastic bag. Cover the pack or bag with a towel before you apply it to your skin. Apply ice for 15 to 20 minutes every hour, or as directed.
  • Bathe as directed. You may be able to take a shower about 2 days after surgery. Remove the dressings before you shower. Do not remove the tape strips covering the incision area. Pat the area dry with a clean towel after your shower. Wrap the incision area as directed after your skin is dry.
  • Use crutches if directed. If your fasciotomy was done on a leg, you may need to use crutches until you heal. Crutches will help keep pressure off your leg. Ask your healthcare provider how long you need to use crutches.
  • Eat a variety of healthy foods. Healthy foods give your body the nutrients it needs to heal your wound. Healthy foods include fruits, vegetables, grains (breads and cereals), dairy, and protein foods. Protein foods include meat, fish, nuts, and soy products. Protein, calories, vitamin C, and zinc help wounds heal. Ask for more information about the foods you should eat to improve healing.
  • Drink more liquids. Liquids prevent dehydration that can decrease the blood supply to your wound. Ask your healthcare provider how much liquid to drink each day.

Go to physical or occupational therapy if directed:

A physical therapist can teach you exercises to improve muscle strength and flexibility. An occupational therapist can help you learn to do your daily activities in a new way if needed. Physical and occupational therapy can help reduce pain and make movement easier.

Follow up with your healthcare provider as directed:

Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Further information

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