Compartment Syndrome

Under a compartment syndrome is meant an increased tissue pressure within a fixed Faszienkompartments with a Gewebischämie as a result. The first sign is a disproportionately large, standing out of proportion to the injury pain. The diagnosis is usually by measuring the Kompartmentdrucks. The treatment consists of fasciotomy.

The compartment syndrome is a self-sustaining cascade of individual pathological processes. It begins with a tissue edema, which develops normally after an injury such. For example, by a soft tissue swelling or hematoma. Occurs such edema within a closed Faszienkompartments, typically in the front or rear compartments for the leg, is representative of this expansion is not enough room at disposal, so that the interstitial (Kompartment-) increases pressure. If the pressure within the compartment normal capillary pressure by approximately 8 mm Hg, the cellular perfusion is slowed down and may eventually adjourn. (NOTE: Since 8 mm Hg are far less than the arterial blood pressure, cellular perfusion can stop long before the disappearance of the pulses.) The resulting tissue ischemia worsens in a vicious circle, the edema in addition.

Under a compartment syndrome is meant an increased tissue pressure within a fixed Faszienkompartments with a Gewebischämie as a result. The first sign is a disproportionately large, standing out of proportion to the injury pain. The diagnosis is usually by measuring the Kompartmentdrucks. The treatment consists of fasciotomy. The compartment syndrome is a self-sustaining cascade of individual pathological processes. It begins with a tissue edema, which develops normally after an injury such. For example, by a soft tissue swelling or hematoma. Occurs such edema within a closed Faszienkompartments, typically in the front or rear compartments for the leg, is representative of this expansion is not enough room at disposal, so that the interstitial (Kompartment-) increases pressure. If the pressure within the compartment normal capillary pressure by approximately 8 mm Hg, the cellular perfusion is slowed down and may eventually adjourn. (NOTE: Since 8 mm Hg are far less than the arterial blood pressure, cellular perfusion can stop long before the disappearance of the pulses.) The resulting tissue ischemia worsens in a vicious circle, the edema in addition. When the ischemia progresses, muscles become necrotic, sometimes leading to rhabdomyolysis, infections and hypercalcemia; these complications can cause loss of limbs and left untreated death. Hypotension or arterial insufficiency may affect, resulting in a deterioration of the compartment syndrome tissue perfusion even at slightly elevated Kompartmentdrücke. Contractures can after the necrotic tissue has healed develop. The compartment syndrome is a disease of the extremities in the first place and is found most commonly in the lower leg and forearm. However, the compartment syndrome may occur at other locations (eg. As the upper arm, abdomen, buttocks). Etiology Common causes include fractures Strong pinching or crushing injuries reperfusion damage after vascular injury and opeation Among the rare causes include snake bites, burns, severe overload, drug overdose (heroin or cocaine), plaster casts, close bandages, and other rigid and strong associations that inhibit swelling and thus increasing the Kompartmentdruck. Prolonged pressure on a muscle during a coma may have rhabdomyolysis result. Symptoms and signs The earliest symptom is worsening pain he is typically not commensurate with the severity of the injury and can by passive stretching of muscles within the Kompartmentes (z. B. in front Unterschenkelkompartment by passive plantar flexion of the joint and by passive toe diffraction that the anterolateral Muskelkompartiment stretches) are worse. Besides pain, one of the main symptoms of tissue ischemia, there are four other symptoms: paraesthesia, paralysis, pallor and no pulse. The halftime compartments are tense on palpation. Tips and risks If the pain is more severe than would obviously be expected for the severity of injury, unplug the compartment syndrome into consideration; check for pain attacks with passive muscle stretching, and if compartments are felt, check for tension. Diagnosis The diagnosis is made by measuring the Kompartmentdrucks. The diagnosis must be set and treatment should be started before pallor and Pulslosigkeit be considered signs of necrosis. A clinical evaluation is difficult for various reasons: How to perform a tissue pressure measurement arm. © Elsevier Inc. All rights reserved. This video is personal information. The users to copy, reproduce, license, subscribe, sell, rent or distribution is prohibited by this video. var model = {videoId: ‘4611252650001’, playerId ‘H1xmEWTatg_default’, imageUrl ‘http://f1.media.brightcove.com/8/3850378299001/3850378299001_4611301761001_vs-56462159e4b071da277559a8-767904719001.jpg?pubId=3850378299001&videoId=4611252650001’ title: ‘How to make a tissue pressure measurement arm.’, description: ” credits’ © Elsevier Inc. All rights reserved. This video is personal information. The users to copy, reproduce, license, subscribe, sell, rent or distribution is prohibited by this video ‘, hideCredits: true hideTitle: false, hideDescription: true loadImageUrlWithAjax: true};. var panel = $ (MManual.utils.getCurrentScript ()) Closest ( ‘video element panel..’); ko.applyBindings (model, panel.get (0)); How to perform a tissue pressure measurement leg © Elsevier Inc. All rights reserved. This video is personal information. The users to copy, reproduce, license, subscribe, sell, rent or distribution is prohibited by this video. var model = {videoId: ‘4611252632001’, playerId ‘H1xmEWTatg_default’, imageUrl ‘http://f1.media.brightcove.com/8/3850378299001/3850378299001_4611287589001_vs-56461fb6e4b071da27755989-782203287001.jpg?pubId=3850378299001&videoId=4611252632001’ title: ‘How can a tissue pressure measurement in the leg performs’ description:’ ‘credits’ © Elsevier Inc. All rights reserved. This video is personal information. The users to copy, reproduce, license, subscribe, sell, rent or distribution is prohibited by this video ‘, hideCredits: true hideTitle: false, hideDescription: true loadImageUrlWithAjax: true};. var panel = $ (MManual.utils.getCurrentScript ()) Closest ( ‘video element panel..’); ko.applyBindings (model, panel.get (0)); Typical symptoms and findings may be missing. Findings are not specific, as similar results are sometimes caused by the fracture itself. Many trauma patients have an altered mental status due to other injuries and / or sedation. Therefore, doctors need to risk of injury to a low limit value in the measurement of compartmental set (normal value ? 8 mmHg) in patients, usually with a commercial pressure monitor. The compartment syndrome is confirmed when the kompartmentale pressure is greater than about 30 mm Hg, or within about 30 mm Hg diastolic blood pressure. Therapy fasciotomy The initial treatment is the removal of any constraining structure (eg. As gypsum, rail) around the limb, correction of hypotension, analgesia and additional oxygen as needed. As a rule, unless the chamber pressure decreases rapidly and the symptoms subside, a fasciotomy is required urgently. Fasciotomy should be performed by large incisions to open all fascial compartments in the limb and thus relieve the pressure. All muscles should be carefully analyzed for viability, and any non-viable tissue should be debrided. Amputation is displayed when the necrosis is extensive. Key Points Once the process that triggers the compartment syndrome begins, the compartment syndrome tends to increase in severity. Pull the compartment syndrome into consideration when the pain out of proportion seem to be to the severity of the injury, and if these aggravated by passive stretching of the muscles within the compartment, or if the compartment is tight. Measure the pressure in the compartment to confirm the diagnosis; a finding of more than about 30 mm Hg, or within about 30 mm Hg diastolic blood pressure confirms this. Fasciotomy must be performed as quickly as possible, unless resolves quickly after the first treatment the disorder.

Health Life Media Team

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