Treatment Of Compartment Syndrome Caused By Venomous Snakebites:Early Fasciotomy Combined With Vacuum Sealing Drainage

Objective:To explore whether early fasciotomy combined with vacuum sealing drainage（VSD）is beneficial for improving the prognosis of snakebite patients who developed compartment syndrome.Methods:We retrospectively reviewed the patients who presented to our institution with snakebites between October 1,2012,and September 30,2021.Snakebite patients,who developed compartment syndrome and then underwent fasciotomy combined with VSD or only fasciotomy,were included in this study.Demographic characteristics,clinical features,laboratory data,and clinical outcomes were recorded.R software（version 3.6.3）was used to analysis data.Results:A total of 2860 patients with snakebites were admitted to our hospital between October 1,2012 and September 30,2021.Among these,56 cases experienced compartment syndrome were treated with a combination of fasciotomy and VSD,and 22 cases were treated with fasciotomy only.Patients treated with a combination of fasciotomy and VSD had lower incidence of limb-related complications,less wound skin necrosis and less limb dysfunction,and had shorter hospitalization time after surgery than those treated with fasciotomy only（P<0.05）.Regarding laboratory parameters,white blood cell counts（WBC）,the percentage of the neutrophil（NEUT%）,aspartate aminotransferase（AST）,total bilirubin（TBIL）,direct bilirubin（DBIL）,indirect bilirubin（IBIL）,and coagulation function indicators improved after surgery,and the differences between the parameters before and after operation showed statistical significance（P<0.05）.Of 56 patients treated with a combination of fasciotomy and VSD,12 patients experienced early surgery（≤6 h from injury to surgery）,and 44 patients experienced non-early surgery（>6 h from injury to surgery）.Compared with patients experienced non-early surgery,those experienced early surgery had shorter hospitalization time（P<0.05）.Conclusion:Early fasciotomy combined with VSD is beneficial for reducing the occurrence of limb-related complications,wound skin necrosis and limb dysfunction,and shortening hospitalization time after surgery,thus improving the prognosis of snakebite patients with compartment syndrome.