Closing Under Pressure: Addressing Surgical Fasciotomy Wounds in a Pediatric Patient

Acute compartment syndrome is a limb threatening emergency requiring urgent surgical release of the involved compartments.

This procedure involves extensive incisions to provide adequate release of the involved myofascial compartments. As this condition is associate with significant disruption and edema of the soft tissues, primary closure after this surgical procedure is rarely possible leading to increased risk of morbidity to the patient. In this case we present the successful treatment of extensive fasciotomy wounds in a 16-year-old who incurred acute compartment syndrome after an elective bunion surgery.

By utilizing NPWT to manage soft tissue edema and advanced skin substitute placement, these wounds achieved closure without further complication and avoiding the risks of surgical harvest and application of skin grafts. Given the rare occurrence of compartment syndrome, it is our hope by presenting this case we can guide clinicians who encounter these unusual wounds in their practice to be able to provide for the best possible outcomes for their patients.