[abstract] MANAGEMENT OF THE SKELETAL MUSCLE-COMPARTMENT SYNDROME, THE ROLE OF HYPERBARIC OXYGEN

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[abstract] MANAGEMENT OF THE SKELETAL MUSCLE-COMPARTMENT SYNDROME, THE ROLE OF HYPERBARIC OXYGEN

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Title: [abstract] MANAGEMENT OF THE SKELETAL MUSCLE-COMPARTMENT SYNDROME, THE ROLE OF HYPERBARIC OXYGEN
Author: Strauss, MB
Abstract: BACKGROUND: Although laboratory evidence strongly supports the use of hyperbaric oxygen (HBO) for the skeletal muscle-compartment syndrome (SMCS), its clinical application has been limited. This is due, in part, to confusion as to when HBO is indicated. This presentation clarifies the indications for HBO in the SMCS with respect to the stages of compartment syndrome and the currently accepted criteria for fasciotomy. METHODS: SMCS's evolve through three stages: (1) Suspected; (2) Impending, and (3) Manifested. During each stage specific findings are present and appropriate interventions are indicated. In the stage of Impending SMCS, HBO is indicated if compartment pressure criteria and/or clinical evaluation do not indicate that a fasciotomy is needed. Unfortunately, there is no consensus on the compartment pressure that dictates when a fasciotomy should be done. Different "authorities" have established their own pressure criteria for fasciotomy. If a fasciotomy is done for a Manifested compartment syndrome and residual problems such as muscle ischemia, threatened flaps, etc. exist) HBO should be used as adjunct to tissue salvage and wound healing. RESULTS: By using the above criteria in 20 patients with the SMCS we have observed arrest of progression from the Impending stage and elimination of the need for fasciotomy in all. When used after fasciotomy (i.e. the Manifested stage) HBO's benefits are analogous to these seen when it is used for threatened flaps, acute peripheral ischemias, and mixed infections. CONCLUSIONS: A knowledge of the stages of the SMCS and when HBO is indicated can lessen the morbidity associated with this problem.
Description: Undersea and Hyperbaric Medical Society, Inc. (http://www.uhms.org )
URI: http://archive.rubicon-foundation.org/964
Date: 2001

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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