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

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

• A. When time between onset and surgery is less than 6 hours
• B. When there is significant swelling
• C. When time between onset and surgery is greater than 6 hours
• D. Only if patient is in shock

Answer: (C)

Fasciotomy is a surgical procedure performed to relieve pressure in cases of acute compartment syndrome, which can occur following ischaemia. The decision to perform a fasciotomy after surgery for acute limb ischaemia is largely dependent on the critical timing of ischaemia and subsequent reperfusion injuries. When ischaemia lasts longer than approximately 6 hours, the risk of irreversible muscle and nerve damage increases significantly due to the build-up of metabolic waste products and the lack of blood supply. This timeframe is crucial because tissues start to undergo necrosis after this period. Therefore, if surgery has been performed for acute limb ischaemia and the time between onset of ischaemia and surgical intervention extends beyond 6 hours, fasciotomy may be indicated to prevent permanent damage. While swelling and shock are important clinical signs and may influence management, they alone do not determine the need for fasciotomy. The timing of ischaemia in relation to surgery is more pivotal in deciding if fasciotomy is necessary. Therefore, in the context of addressing the potential for irreversible damage and the condition of the muscles and nerves involved, performing a fasciotomy when the time between onset of ischaemia and surgery is greater than 6 hours is an appropriate clinical

Fasciotomy is a surgical procedure performed to relieve pressure in cases of acute compartment syndrome, which can occur following ischaemia. The decision to perform a fasciotomy after surgery for acute limb ischaemia is largely dependent on the critical timing of ischaemia and subsequent reperfusion injuries.

When ischaemia lasts longer than approximately 6 hours, the risk of irreversible muscle and nerve damage increases significantly due to the build-up of metabolic waste products and the lack of blood supply. This timeframe is crucial because tissues start to undergo necrosis after this period. Therefore, if surgery has been performed for acute limb ischaemia and the time between onset of ischaemia and surgical intervention extends beyond 6 hours, fasciotomy may be indicated to prevent permanent damage.

While swelling and shock are important clinical signs and may influence management, they alone do not determine the need for fasciotomy. The timing of ischaemia in relation to surgery is more pivotal in deciding if fasciotomy is necessary. Therefore, in the context of addressing the potential for irreversible damage and the condition of the muscles and nerves involved, performing a fasciotomy when the time between onset of ischaemia and surgery is greater than 6 hours is an appropriate clinical