Response to Letter to the Editor: ‘Comment on epidemiology of childhood electrocution in Bangladesh’

Abstract

of acute compartment syndrome (ACS) and therefore, a fasciotomy should be not recommended. The difficulty of diagnosis of ACS in burn patients lays on the absence of clinical signs because there are patients who are often sedated and connected to mechanical ventilation and interpretation of the intracompartment measurement should be done in the clinical context of the patient. Surgical decompression of limbs with severe burns is proposed to allow safer and more effective management. Subsequent monitoring to assess the adequacy of tissue perfusion is necessary and if there is evidence of continuous compromise particularly of muscle perfusion in closed compartment should be decompressed [1]. Measurement of compartment pressure in limbs of patients with serious burns and risk factors for ACS should be incorporated into ''carebundle'' for the management of patients with major burns [2]. Using the large needle Stryker arises as a good choice for initial management of patients with suspected ACS with severe burns, but its implementation requires validation in further clinical studies. Nevertheless, in patients without risk factors for the development of ACS, the assessment of compartment pressure should be balanced to avoid possible misinterpretations of the measurement to prevent complications associated with unnecessary fasciotomies such as underlying damage to structures and infection. However, the aim of our study is not to describe the diagnosis and the surgical procedures of ACS, but to call attention to associated factors with intracompartmental sepsis [3].