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Fasciotomy in Children
WHAT YOU NEED TO KNOW:
What do I 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 do I prepare my child for a fasciotomy?
- Fasciotomy is often done as emergency surgery because pressure builds up suddenly. This means you might not have time to prepare your child. If you can prepare, your child's surgeon will tell you what to do. The surgeon may tell you not to let your child eat or drink anything before midnight on the day of surgery. You will be told which medicines your child can take or not take on the day of surgery. Tell your child's surgeon if your child has ever had problems with anesthesia.
- Your child may be given antibiotics to prevent a bacterial infection. Tell your child's surgeon if your child has ever had an allergic reaction to an antibiotic.
What will happen during a fasciotomy?
- Your child may be given general anesthesia to keep him or her asleep and free from pain during surgery. Depending on your child's age, he or she may instead be given regional anesthesia to numb the surgery area. Your child will be awake with regional anesthesia, but he or she should not feel pain. Your child's surgeon will make one or more incisions in the skin and fascia. This will relieve pressure that has built up in the area.
- Your child's surgeon may leave the incision 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 child's 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 child's 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 child's skin. You may need to remove and wrap the area regularly. Your child's healthcare provider will tell you how often to do this.
What are the risks of a fasciotomy?
Nerves may be damaged or destroyed near the surgery site. Your child may develop necrosis (tissue death). He or she will need more surgery to remove the tissue if this happens.
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