Timing of surgical intervention for compartment syndrome in different body region: systematic review of the literature

• Main Authors: Federico Coccolini, Mario Improta, Edoardo Picetti, Luigi Branca Vergano, Fausto Catena, Nicola de ’Angelis, Andrea Bertolucci, Andrew W. Kirkpatrick, Massimo Sartelli, Paola Fugazzola, Dario Tartaglia, Massimo Chiarugi
• Format: Article
• Language: English
• Published: BMC 2020-10-01
• Series: World Journal of Emergency Surgery
• Subjects: Hypertension; Decompressive craniectomy; Compartment syndrome; Extremities; Ocular; Plycompartment
• Online Access: http://link.springer.com/article/10.1186/s13017-020-00339-8

Abstract Compartment syndrome can occur in many body regions and may range from homeostasis asymptomatic alterations to severe, life-threatening conditions. Surgical intervention to decompress affected organs or area of the body is often the only effective treatment, although evidences to assess the best timing of intervention are lacking. Present paper systematically reviewed the literature stratifying timings according to the compartmental syndromes which may beneficiate from immediate, early, delayed, or prophylactic surgical decompression. Timing of decompression have been stratified into four categories: (1) immediate decompression for those compartmental syndromes whose missed therapy would rapidly lead to patient death or extreme disability, (2) early decompression with the time burden of 3–12 h and in any case before clinical signs of irreversible deterioration, (3) delayed decompression identified with decompression performed after 12 h or after signs of clinical deterioration has occurred, and (4) prophylactic decompression in those situations where high incidence of compartment syndrome is expected after a specific causative event.