A fasciotomy is a procedure that involves cutting into the fascia, a layer of connective tissue that encases muscles and other tissues. It is done to relieve built-up pressure inside muscle compartments.
Pressure can build up in a muscle compartment, restricting blood flow and causing pain or other symptoms. This is called compartment syndrome.
A fasciotomy is often an emergency treatment for acute compartment syndrome.
This article discusses details, including why a person may need a fasciotomy and what to expect before, during, and after the procedure.
Every structure in the body, including nerves, organs, and muscles, is encased within a thin layer of connective tissue called the fascia.
The fascia has many functions, including:
- holding structures in place within the body
- providing a protective layer
- playing a role in body movement
Some conditions can cause a buildup of pressure within a muscle compartment. A compartment refers to a segment or grouping of any muscles, nerves, or vessels in the arms and legs covered by a tough membrane called the fascia.
As the fascia covering these tissues is
Most people who need a fasciotomy have a condition called compartment syndrome.
It occurs when pressure in a muscle compartment builds to dangerous levels, decreasing blood flow to the affected area. Swelling or bleeding in the muscle is usually the underlying cause.
Left untreated, this pressure can cause damage to the blood vessels and nerves. It can also prevent the flow of blood into a compartment. This can have serious consequences for a person.
Compartment syndrome
Symptoms include:
- pain, especially when extending the affected limb
- tingling or prickling
- pale coloring in the affected limb
- weak or no pulse in the affected compartment
There are two types of compartment syndrome: acute and chronic. Acute compartment syndrome is the most common type and generally happens when a person experiences a severe traumatic injury.
Chronic compartment syndrome can happen when a person has repeated athletic exertion. Another name for it is exertional compartment syndrome. This type is not usually an emergency.
A fasciotomy is
Doctors may perform a physical exam or certain imaging tests to confirm a diagnosis of acute compartment syndrome. However, the priority is to perform the fasciotomy as soon as possible.
Preparation for a fasciotomy
Sometimes, a surgeon may collect the compartment’s pressure before the surgery. To do this, they will place a pressure gauge into the compartment to measure its pressure. If the pressure is elevated, this further confirms a person has compartment syndrome.
A person may need to avoid eating and drinking in the time leading up to the surgery. However, in emergencies, this may not always be possible.
For a fasciotomy, the person having surgery will be under either general or local anesthesia. This means they may be conscious during the procedure, but should not feel any pain.
A person will be lying on their back for the surgery, and the surgical team will drape the part of the body where they will perform the procedure.
During a fasciotomy
During the procedure, the surgeon will make an incision into the area, so they can see the outer layer of the fascia.
They will then carefully make an incision through the fascia to relieve the pressure in the compartment.
Once the surgical team can see inside the compartment, they will investigate the area, looking for signs of damage or dead tissue. If there is a dead muscle inside the compartment, the surgeon will remove it.
After a fasciotomy
After completing the procedure, the surgeon usually leaves the incision open so the pressure does not begin to build up again. In the days following the procedure, they may use stitches to close the incision or leave it to heal on its own.
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When recovering from a fasciotomy, a healthcare team will provide wound care, ensure the incision is healing correctly, and help the individual manage any pain or discomfort.
The wound can take 4 to 6 weeks or longer to heal fully. Some people may need physical therapy to regain normal movement in the affected area.
Some things a person can do to help them recover include:
- avoiding smoking
- eating a healthy diet
- staying hydrated
- completing physical therapy
A person should follow any instructions from a healthcare team on how to care for their wound after leaving the hospital.
A person needs to keep the healthcare team informed of any changes or issues they are experiencing, such as increased pain or fever, as these could be signs of infection.
A fasciotomy is generally a safe procedure. However, like all surgery, this procedure carries some risks of complications.
Possible complications include:
- wound infection
- bleeding
- permanent muscle or nerve damage
- tendon damage
- kidney failure due to dead muscle tissue
- amputation due to severe muscle damage
What is a fasciotomy procedure?
A fasciotomy is a surgery that involves cutting through the fascia, the layer of connective tissue that encases a muscle compartment, to relieve built-up pressure.
What causes the need for a fasciotomy?
Most people who need a fasciotomy have compartment syndrome. This means that pressure builds up in a muscle compartment due to swelling, bleeding, or other fluid buildup.
Compartment syndrome can occur due to severe injury or repeated athletic exertion over time.
How risky is a fasciotomy?
A fasciotomy is a common and generally safe procedure. However, all surgeries carry some risks of complications. Many complications associated with a fasciotomy are a result of an underlying condition rather than the surgery itself.
Still, as fasciotomy often results in an open wound, there may be a slightly higher risk of certain complications, such as infection.
Does the fascia grow back after a fasciotomy?
No, the fascia does not grow back after a fasciotomy. However, as the wound heals, scar tissue forms in the place of the incision and reconnects the fascia. This scar tissue can restore the fascia’s integrity and perform a similar function to the original tissue.
A fasciotomy is a surgical procedure a person may need if pressure builds up in a muscle compartment. Cutting into the fascia encasing the compartment can relieve this pressure and help avoid serious complications.
If left untreated, compartment syndrome can cause dangerous complications. A fasciotomy can effectively treat this condition, and many people recover typical function after surgery.