Bedside Drainage After Fasciotomy
There is no specific named procedure for draining blood at the bedside after fasciotomy—the standard approach is to leave fasciotomy wounds open initially with planned delayed closure, not to drain them with a specific procedure 1, 2.
Standard Post-Fasciotomy Wound Management
Fasciotomy wounds should be left open initially and managed with negative pressure wound therapy (NPWT), not drained with a bedside procedure 1, 2. The American College of Cardiology explicitly recommends leaving fasciotomy wounds open after the procedure and planning for delayed closure 1, 2.
Immediate Post-Fasciotomy Care
- Wounds remain open to allow continued decompression and prevent recurrent compartment syndrome 1, 2
- NPWT (vacuum-assisted closure/VAC therapy) is applied to the open fasciotomy wounds to facilitate wound closure or prepare the wound bed for skin grafting 1, 2
- Early delayed primary closure can be attempted at a median of 5 days if minimal tissue bulge occurs or resolves with systemic diuresis and leg elevation 1
What NOT to Do
Subfascial drains are NOT recommended after fasciotomy or other surgical procedures, as they provide no benefit in reducing hematoma formation or surgical site infections 3, 4. In fact, drain use after surgical procedures is associated with:
- 14-fold increased risk of requiring post-operative blood transfusion 4
- Nearly 2-fold increase in hospital length of stay 4
- No reduction in hematoma or infection rates 3, 4
Alternative Bedside Procedures (If Relevant)
If you are asking about performing the fasciotomy itself at bedside (rather than draining afterward), bedside fasciotomy under local anesthesia is feasible in selected cases when there is anticipated delay to the operating room 5. However, this is the fasciotomy procedure itself, not a drainage procedure afterward 5.
Critical Pitfall to Avoid
Do not attempt to "drain" fasciotomy wounds with tubes or drains—this contradicts the fundamental principle that these wounds must remain open for ongoing decompression 1, 2. The blood and fluid that accumulate are managed through the open wound itself, with NPWT assisting in fluid removal and wound preparation 1, 2.