Fasciotomy or fasciectomy is a surgical procedure where the fascia

Fascia

A fascia is a layer of fibrous tissue that permeates the human body. A fascia is a connective tissue that surrounds muscles, groups of muscles, blood vessels, and nerves, binding those structures together in much the same manner as plastic wrap can be used to hold the contents of sandwiches...

 is cut to relieve tension or pressure (and treat the resulting loss of circulation

Circulatory system

The circulatory system is an organ system that passes nutrients , gases, hormones, blood cells, etc...

 to an area of tissue

Biological tissue

Tissue is a cellular organizational level intermediate between cells and a complete organism. A tissue is an ensemble of cells, not necessarily identical, but from the same origin, that together carry out a specific function. These are called tissues because of their identical functioning...

 or muscle

Muscle

Muscle is a contractile tissue of animals and is derived from the mesodermal layer of embryonic germ cells. Muscle cells contain contractile filaments that move past each other and change the size of the cell. They are classified as skeletal, cardiac, or smooth muscles. Their function is to...

). Fasciotomy is a limb-saving procedure when used to treat acute compartment syndrome

Compartment syndrome

Compartment syndrome is a limb threatening and life threatening condition, defined as the compression of nerves, blood vessels, and muscle inside a closed space within the body . This leads to tissue death from lack of oxygenation due to the blood vessels being compressed by the raised pressure...

. It is also sometimes used to treat chronic compartment stress syndrome. The procedure has a very high rate of success, with the most common problem being accidental damage to a nearby nerve.

Complications

Complications can also involve the formation of scar tissue after the operation. A thickening of the surgical scars can result in the loss of mobility of the joint involved. This can be addressed through occupational or physical therapy.

Process

Fasciotomy in the limbs is usually performed by a surgeon under general or regional anesthesia. An incision is made in the skin, and a small area of fascia is removed where it will best relieve pressure.

Plantar fasciotomy is an endoscopic

Endoscopy

Endoscopy means looking inside and typically refers to looking inside the body for medical reasons using an endoscope , an instrument used to examine the interior of a hollow organ or cavity of the body. Unlike most other medical imaging devices, endoscopes are inserted directly into the organ...

 procedure. The doctor makes two small incisions on either side of the heel. An endoscope is inserted in one incision to guide the doctor. A tiny knife is inserted in the other. A portion of the fascia near the heel is removed. The incisions are then closed.

In addition to scar formation, there is a possibility that the surgeon may need to use a skin graft to close the wound. Sometimes when closing the fascia again in another surgical procedure, the muscle is still too large to close it completely. A small bulge is visible, but is not harmful.

Indications

Compartment syndrome

Compartment syndrome

Compartment syndrome is a limb threatening and life threatening condition, defined as the compression of nerves, blood vessels, and muscle inside a closed space within the body . This leads to tissue death from lack of oxygenation due to the blood vessels being compressed by the raised pressure...

is one of the conditions where a fasciotomy may be indicated. People who are likely to suffer injuries needing a fasciotomy include the following:

• Victims of vehicular accidents or crush injuries
• Athletes who have sustained one or more serious impact injuries
• People who spend long periods of time on their feet
• People with severe burns
• Persons who are severely overweight

Contrary to common surgical practice, fasciotomy is rarely indicated for snakebite victims.