Soft tissue wounds and fasciotomies

The soft tissue wounds seen in combat are extensive and rare if never seen in civilian training or practice. No amount of reading can completely prepare one for some of these injuries, and a different set of rules and strategies must be adopted to optimize outcomes. Additionally, it is essential that the combat surgeon be well versed in recognizing compartment syndromes and performing timely and complete fasciotomies. It is a travesty to have a young solider survive a multitude of potentially life-threatening injuries only to lose a limb or life due to a delayed or improperly performed extremity fasciotomy. The goal of this chapter is to help shorten the learning curve to care for the extensive soft tissue wounds of war and to reinforce the importance of both identifying compartment syndromes and treating them with correctly performed fasciotomies.