When should fasciotomy be performed after surgery for acute limb ischaemia?

Fasciotomy is a surgical procedure aimed at relieving pressure in cases of acute limb ischaemia, often due to compartment syndrome. The indication for performing fasciotomy is primarily based on the duration of limb ischaemia and the subsequent risk of muscle and nerve damage.

When the time between the onset of ischaemia and surgical intervention exceeds 6 hours, the risk of irreversible damage to muscles and nerves significantly increases. This irreversible damage can lead to complications such as rhabdomyolysis and permanent functional impairment of the limb. Therefore, performing fasciotomy after 6 hours is often considered necessary to prevent further complications and to preserve limb viability.

In addition, when fasciotomy is delayed beyond this period without addressing the underlying ischaemia, it may result in a situation where the muscle becomes necrotic, which complicates subsequent surgical management and recovery.

The importance of timely intervention is critical when managing acute limb ischaemia. Addressing this condition promptly is crucial to restoring perfusion, preventing more extensive tissue necrosis, and allowing for better outcomes following surgery.