Compartment Syndrome Due to Patient Positioning

Excerpt

Introduction

The development of a compartment syndrome is based on rising pressure in a defined compartment. Patient positioning is a critical step of any surgical procedure. Inadequate positioning can lead to soft tissue damages and to the development of compartment syndrome.

General Considerations

A compartment syndrome results from decreased perfusion in well-defined physiological space, associated with increased compartment pressure. Risk factors include prolonged direct pressure of the affected compartment, venous obstruction, insufficient perfusion, inappropriate fluid accumulation, and coagulopathy. One of the most important risk factors however is the prolonged duration of the procedure.

Most Common Position Associated with Compartment Syndrome

The lithotomy position carries several risk factors that may provoke a compartment syndrome of the lower extremity. These risk factors include pressure on the elevated leg and venous obstruction in the inguinal region.

Conclusion

Special care has to be observed during the preparation for surgery. Preparation includes proper positioning and reduction of duration of the procedure. With these factors in mind, the prevalence of compartment syndromes due to patient positioning may be reduced.