Publication:

An unusual presentation of compartment syndrome following deep venous thrombosis

A young female in her early 30s was admitted in medicine department of our hospital for swelling in left lower limb with decreased urine output. She had history of lower segment caesarean section (LSCS) done for obstructed labour and was bedridden. Venous color Doppler was done which was suggestive of deep vein thrombosis (DVT) in left lower limb. Surgery reference was sent for increased left lower limb swelling. On examination there was compartment syndrome in left lower limb for which urgent fasciotomy was done in emergency setting and patient was transferred under surgery department. Later debridement was done for unhealthy muscles and multiple cycles of VAC were applied when wound was healthy and granulated. In between VAC dressings, hypertonic saline dressings were also done to decrease muscle oedema. Patient was kept on LMWH injection. Patient was discharged on Tab Dabigatran after approximately 1 month of admission with stable vitals and edematous left lower limb. After 4 cycles of VAC application patient was planned for STSG. Debridement and STSG from right thigh to cover raw area along with assistance from plastic surgery department. Patient was vitally stable postoperatively with minimal soakage was done of right thigh donor area. Postoperatively dressing was removed which showed healthy graft uptake with no collection underneath it.