Management of Compartment Syndrome in Severe Trauma: Diagnosis, Surgical Intervention, and Postoperative Care

Abstract

Compartment syndrome is a medical emergency that occurs when pressure within a fascial compartment rises to critical levels, leading to impaired blood flow and subsequent tissue ischemia. This study aimed to deepen the understanding of compartment syndrome management in severe trauma, focusing on early diagnosis, appropriate surgical interventions, and integrated postoperative care. A comprehensive literature review and critical analysis of current clinical practices were conducted. The pathophysiology of compartment syndrome involves a critical increase in intracompartmental pressure, often triggered by fractures, crush injuries, or burns, leading to decreased capillary perfusion and tissue hypoxia. Early recognition of clinical signs, such as disproportionate pain, paresthesia, and paralysis, is crucial, and intracompartmental pressure monitoring is vital for accurate diagnosis. The gold standard treatment is fasciotomy, which, when performed promptly, can prevent irreversible ischemic damage. The decision to perform fasciotomy should be based on clinical signs and pressure measurements, with the procedure ideally occurring within six hours of symptom onset. Postoperative care, including edema management, infection prevention, and wound closure, plays a critical role in patient recovery. Successful management of compartment syndrome not only depends on timely surgical intervention but also on meticulous postoperative care and intensive rehabilitation. The study concludes that while fasciotomy remains the primary intervention, early diagnosis, vigilant postoperative care, and comprehensive rehabilitation are essential to minimize complications and improve long-term functional outcomes for patients with compartment syndrome.