Is ACS an emergency?
ACS is a surgical emergency and requires emergent fasciotomy, as irreversible tissue necrosis and functional impairment can occur within 4–6 hours of onset.
Describe the supportive therapy.
Remove constrictive dressings, splints, and devices.
Provide systemic analgesia.
Place the limb at the level of the heart.
Reduce displaced fractures.
Administer supplemental oxygen.
Describe the surgical treatment.
Indications: strongly suspected or confirmed acute compartment syndrome
Fasciotomy: incision(s) in the skin and fascia to relieve compartment pressure and restore perfusion
Perform emergently to prevent irreversible injury.
Postoperative wound treatment: usually left open for delayed primary closure
Escharotomy: incision of circumferential compressing burn eschar
Fibulectomy: removal of the fibula to decompress all four compartments of the leg