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The Journal of Cardiovascular Surgery 1998 October;39(5):587-91

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Temporary wound covering with a silicon sheet for the soft tissue defect following open fasciotomy. Technical note

Bail D. H. L., Schneider W., Khalighi K., Seboldt H.

From the Department of Thoracic and Cardiovascular Surgery University of Tübingen,Tübingen, Germany (Medical Director: Prof. Dr. G. Ziemer)


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Objective. Temporary cov­er­ing of a ­defect of the ­soft tis­sues ­with a sil­i­con ­sheet ­after fas­cio­to­my in the treat­ment of com­part­ment syn­drome.
Design. Retrospective ­study.
Setting. University Hospital, Tübingen.
Patients. From January 1991 to June 1996, ­open fas­cio­to­my was per­formed a ­total of 18 ­times on 17 ­patients ­with com­part­ment syn­drome. In 17 of the 18 cas­es ­acute vas­cu­lar ische­mia was the ­cause of the com­part­ment syn­drome.
Interventions. For the 18 nec­es­sary fas­cio­to­mies, a sil­i­con ­sheet was tem­po­rar­i­ly ­used to cov­er the ­defect of the ­soft tis­sue tem­po­rar­i­ly a ­total of 9 ­times. The sil­i­con ­sheet was grad­u­al­ly ­drawn togeth­er and the ­wound was final­ly ­closed ­with a sec­on­dary ­suture.
Results. In 6 of the 9 cas­es a sec­on­dary ­suture ­could be per­formed with­out any dif­fi­cul­ties ­after the swell­ing had sub­sid­ed, and a mesh­graft cov­er­ing was not nec­es­sary. Only one ­patient suf­fered ­from ­wound infec­tion ­because the sil­i­con ­sheet had not ­been ­sutured cor­rect­ly. In the oth­er cas­es ­there was no ­sign of infec­tion. The ­wound dress­ing was ­changed pain­less­ly and fur­ther­more, an ­improved cos­met­ic ­result was ­observed.
Conclusions. There are con­sid­er­able advan­tag­es in the use of a sil­i­con ­sheet as a tem­po­rary cov­er­ing for the defe­ct of the ­soft tis­sues in the treat­ment of com­part­ment syn­drome: low­er ­costs ­because of short­er hos­pi­tal­isa­tion and the dress­ing ­change is prac­ti­cal­ly pain­less. A ­reduced ­risk of infec­tion and ­improved cos­met­ic ­results are fur­ther advan­tag­es of ­this meth­od.

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