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 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 should I expect 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.