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Arm Compartment Release - Lateral Approach

Preoperative Patient Care
Operative Techniques

Preoperative Plan


Execute surgical walkthrough

  • describe key steps of the procedure to the attending verbally prior to the start of the case
  • describe potential complications and the steps to avoid them

Room Preparation


Surgical instrumentation

  • curved mayo scissors


Room setup and equipment

  • standard OR table
  • arm board


Patient positioning

  • patient supine

Lateral Approach


Mark and make the incision

  • start the incision at the deltoid insertion
  • extend the incision down to the lateral epicondyle

Deep Dissection


Split the fascia

  • split the fascia that is over the biceps anteriorly and posteriorly


Check the integrity of the soft tissue

  • check the viability of the muscle
  • check the muscle tone, contractility, color and bleeding
  • if viability of the muscle tissue is not clear, reinspect the muscle in 24 to 48 hours


Leave the incision open


Wound Management


Copiously irrigate the wound


Cover the incision with wet saline dressings

  • another option is to use a wound vac
  • this can be done to facilitate care, reduce the edema and decrease the pain that is associated with frequent dressing changes

2nd Look Procedure


Debride necrotic tissue

  • aggressively debride any necrotic tissue with a no. 10 blade in a tangential manner until bleeding tissue is seen


Cover the wounds

  • place moist dressings over large wounds with exposed deep structures of neurovascular structures until coverage can be performed
  • if coverage is not needed, perform moist dressing changes for the next 7 to 14 days once the edema subsides, perform primary closure or skin grafting as needed
Postoperative Patient Care
Private Note

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