Timing of surgical intervention for compartment syndrome in different body region: systematic review of the literature.
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
Author Information
Federico Coccolini: General, Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisia 1, 56100, Pisa, Italy. federico.coccolini@gmail.com. ORCID
Mario Improta: General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy.
Edoardo Picetti: Department of Anesthesia and Intensive Care, Parma University Hospital, Parma, Italy.
Luigi Branca Vergano: Orthopedic Department, Bufalini Hospital, Cesena, Italy.
Fausto Catena: Emergency Surgery Department, Parma University Hospital, Parma, Italy.
Nicola de 'Angelis: Unit of Digestive and Hepato-biliary-pancreatic Surgery, Henri Mondor Hospital and University Paris-Est Créteil (UPEC), Créteil, France.
Andrea Bertolucci: General, Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisia 1, 56100, Pisa, Italy.
Andrew W Kirkpatrick: Departments of Surgery and Critical Care Medicine, Foothills Medical Centre, Calgary, Canada.
Massimo Sartelli: General Surgery Department, Macerata Hospital, Macerata, Italy.
Paola Fugazzola: General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy.
Dario Tartaglia: General, Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisia 1, 56100, Pisa, Italy.
Massimo Chiarugi: General, Emergency and Trauma Surgery Department, Pisa University Hospital, Via Paradisia 1, 56100, Pisa, Italy.
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.
