Nylon Cable-Tie Assisted Forearm Fasciotomy Wound Closure

Abstract

Background: Closure of forearm fasciotomy wounds is challenging. Traditional methods for reconstruction are skin grafts or flaps. A skin graft or flap leaves an unpleasant appearance and requires a donor site. Initially, there is no skin defect or only limited defect. Presented here is a method utilizing looped cable ties for delayed primary closure of forearm fasciotomy wounds.Methods:Patients who underwent fasciotomy of forearms for compartment syndrome and cable tie assisted closure from 2017 to 2020 in Far Eastern memorial Hospital were included. Follow-up observations of all patients were conducted until December 2020. We retrospectively reviewed the cause of forearm compartment syndrome, the initial maximum width of the fasciotomy wounds, and the time for primary closure of the wounds.Results: There were seven patients eligible for inclusion. Four patients suffered from compartment syndrome of the forearm caused by iatrogenic vascular rupture after the procedures. The other reasons for the compartment syndrome included open-type fracture and fasciitis. Emergency fasciotomy was arranged for all the patients, and cable ties were applied for delayed primary wound closure. Six of them, with the median initial maximum width of a wound of 5.15 cm [3.8 - 6.3cm], achieved successful wound closure by cable ties without skin grafts or flaps on median day 12 [ day 6 - 19]. One patient who had distal and proximal radius fracture received skin graft reconstruction after the application of cable ties for 14 days.Conclusion: Cable ties--inexpensive and readily available materials--can be adjusted according to the different tension along the wound edges. They provide a simple, effective, and safe way to close difficult forearm fasciotomy wounds.