Acute forearm compartment syndrome following haemodialysis access fistula puncture in uraemia

Chin-Ta Lin, Niann-Tzyy Dai, Shyi-Gen Chen, Shun-Cheng Chang

研究成果: 雜誌貢獻文章

1 引文 (Scopus)

摘要

Background: Acute compartment syndrome is a well-described surgical emergency that requires immediate diagnosis and operative intervention. Vascular access-associated compartment syndrome is rarely reported in haemodialysis patients. The purpose of this article is to document evidence that catheter-related puncture, which results in arteriovenous fistula injury in uraemia, may cause acute forearm compartment syndrome. Methods: Between September 2007 and September 2012, five consecutive patients presented to our section with tense swollen forearms with skin blistering, decreased hand sensation and reduced capillary return in the fingers. Their ages ranged from 65 to 81 years (mean 72.8 years). All of the patients underwent emergent exploration after the diagnosis of acute forearm compartment syndrome. The patients' details were reviewed. Results: The time interval between dialysis completion and return to the emergency department ranged from 6 to 9h (mean 7.4h). During operation, the bleeding was found to originate from the site of the fistula puncture and was repaired with 9-0 nylon suture under microscopy. After adequate wound care, a reconstructive procedure with a split-thickness skin graft was performed in all of the five patients. There was no vascular or neurological deficit of the forearm or hand within the mean follow-up period of 14.8 months (range 12-18 months). Conclusions: In this series, we report five cases of forearm compartment syndrome in uraemia, secondary to bleeding from a catheter-related puncture of a haemodialysis access fistula. However, there is no case series that focuses upon this specific topic in the present literature. This problem deserves more attention. © 2014 Royal Australasian College of Surgeons.
原文英語
期刊ANZ Journal of Surgery
DOIs
出版狀態已發佈 - 2014
對外發佈Yes

指紋

Compartment Syndromes
Uremia
Punctures
Forearm
Fistula
Renal Dialysis
Blood Vessels
Catheters
Hand
Hemorrhage
Skin
Hypesthesia
Nylons
Arteriovenous Fistula
Wounds and Injuries
Sutures
Fingers
Hospital Emergency Service
Dialysis
Microscopy

引用此文

Acute forearm compartment syndrome following haemodialysis access fistula puncture in uraemia. / Lin, Chin-Ta; Dai, Niann-Tzyy; Chen, Shyi-Gen; Chang, Shun-Cheng.

於: ANZ Journal of Surgery, 2014.

研究成果: 雜誌貢獻文章

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title = "Acute forearm compartment syndrome following haemodialysis access fistula puncture in uraemia",
abstract = "Background: Acute compartment syndrome is a well-described surgical emergency that requires immediate diagnosis and operative intervention. Vascular access-associated compartment syndrome is rarely reported in haemodialysis patients. The purpose of this article is to document evidence that catheter-related puncture, which results in arteriovenous fistula injury in uraemia, may cause acute forearm compartment syndrome. Methods: Between September 2007 and September 2012, five consecutive patients presented to our section with tense swollen forearms with skin blistering, decreased hand sensation and reduced capillary return in the fingers. Their ages ranged from 65 to 81 years (mean 72.8 years). All of the patients underwent emergent exploration after the diagnosis of acute forearm compartment syndrome. The patients' details were reviewed. Results: The time interval between dialysis completion and return to the emergency department ranged from 6 to 9h (mean 7.4h). During operation, the bleeding was found to originate from the site of the fistula puncture and was repaired with 9-0 nylon suture under microscopy. After adequate wound care, a reconstructive procedure with a split-thickness skin graft was performed in all of the five patients. There was no vascular or neurological deficit of the forearm or hand within the mean follow-up period of 14.8 months (range 12-18 months). Conclusions: In this series, we report five cases of forearm compartment syndrome in uraemia, secondary to bleeding from a catheter-related puncture of a haemodialysis access fistula. However, there is no case series that focuses upon this specific topic in the present literature. This problem deserves more attention. {\circledC} 2014 Royal Australasian College of Surgeons.",
keywords = "Compartment syndrome, Forearm, Haemodialysis fistula, Uraemia",
author = "Chin-Ta Lin and Niann-Tzyy Dai and Shyi-Gen Chen and Shun-Cheng Chang",
note = "Export Date: 21 March 2016 Article in Press CODEN: AJSNB 通訊地址: Chang, S.-C.; Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital,電子郵件: aarondakimo@yahoo.com.tw",
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AU - Dai, Niann-Tzyy

AU - Chen, Shyi-Gen

AU - Chang, Shun-Cheng

N1 - Export Date: 21 March 2016 Article in Press CODEN: AJSNB 通訊地址: Chang, S.-C.; Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital,電子郵件: aarondakimo@yahoo.com.tw

PY - 2014

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N2 - Background: Acute compartment syndrome is a well-described surgical emergency that requires immediate diagnosis and operative intervention. Vascular access-associated compartment syndrome is rarely reported in haemodialysis patients. The purpose of this article is to document evidence that catheter-related puncture, which results in arteriovenous fistula injury in uraemia, may cause acute forearm compartment syndrome. Methods: Between September 2007 and September 2012, five consecutive patients presented to our section with tense swollen forearms with skin blistering, decreased hand sensation and reduced capillary return in the fingers. Their ages ranged from 65 to 81 years (mean 72.8 years). All of the patients underwent emergent exploration after the diagnosis of acute forearm compartment syndrome. The patients' details were reviewed. Results: The time interval between dialysis completion and return to the emergency department ranged from 6 to 9h (mean 7.4h). During operation, the bleeding was found to originate from the site of the fistula puncture and was repaired with 9-0 nylon suture under microscopy. After adequate wound care, a reconstructive procedure with a split-thickness skin graft was performed in all of the five patients. There was no vascular or neurological deficit of the forearm or hand within the mean follow-up period of 14.8 months (range 12-18 months). Conclusions: In this series, we report five cases of forearm compartment syndrome in uraemia, secondary to bleeding from a catheter-related puncture of a haemodialysis access fistula. However, there is no case series that focuses upon this specific topic in the present literature. This problem deserves more attention. © 2014 Royal Australasian College of Surgeons.

AB - Background: Acute compartment syndrome is a well-described surgical emergency that requires immediate diagnosis and operative intervention. Vascular access-associated compartment syndrome is rarely reported in haemodialysis patients. The purpose of this article is to document evidence that catheter-related puncture, which results in arteriovenous fistula injury in uraemia, may cause acute forearm compartment syndrome. Methods: Between September 2007 and September 2012, five consecutive patients presented to our section with tense swollen forearms with skin blistering, decreased hand sensation and reduced capillary return in the fingers. Their ages ranged from 65 to 81 years (mean 72.8 years). All of the patients underwent emergent exploration after the diagnosis of acute forearm compartment syndrome. The patients' details were reviewed. Results: The time interval between dialysis completion and return to the emergency department ranged from 6 to 9h (mean 7.4h). During operation, the bleeding was found to originate from the site of the fistula puncture and was repaired with 9-0 nylon suture under microscopy. After adequate wound care, a reconstructive procedure with a split-thickness skin graft was performed in all of the five patients. There was no vascular or neurological deficit of the forearm or hand within the mean follow-up period of 14.8 months (range 12-18 months). Conclusions: In this series, we report five cases of forearm compartment syndrome in uraemia, secondary to bleeding from a catheter-related puncture of a haemodialysis access fistula. However, there is no case series that focuses upon this specific topic in the present literature. This problem deserves more attention. © 2014 Royal Australasian College of Surgeons.

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