Efficacy of the shoelace technique for extremity fasciotomy wounds due to compartment syndrome

Abstract Background The shoelace technique for compartment syndrome allows application of sustained tightening tension to an entire wound and intermittent tightening of the shoelace without requiring replacement or anesthesia. We retrospectively evaluated the usefulness of the shoelace technique in the management of extremity fasciotomy wounds before and after its introduction in our institution. Methods We targeted 25 patients who were diagnosed as having compartment syndrome and underwent extremity fasciotomy at our hospital from April 2012 to December 2021. The N group, comprising 12 patients treated without the shoelace technique, and the S group, comprising 13 patients treated with the shoelace technique, were compared retrospectively for each endpoint. Results There were no significant differences between the two groups in patient background. Compared with the N group patients, a significant number of S group patients avoided skin grafting (S group: n = 0, 0%; N group: n = 6, 50.0%; p < 0.01) and experienced fewer days to final closure (S group: 26.3 ± 13.7 days; N group: 49.6 ± 36.2 days, p = 0.041). Conclusions We considered the shoelace technique to be a useful wound closure method for fasciotomy wounds caused by compartment syndrome because it can reduce skin grafting and shorten the wound closure period.