The Role of Fasciotomy for Limb Salvage in Phlegmasia Cerulea Dolens

Abstract

Phlegmasia cerulea dolens, a complication of ileofemoral thrombosis, fre quently results in venous gangrene and limb loss.^1,2,3 The ischemia associated with phlegmasia cerulea dolens is secondary to venous occlusion, increased pressure in muscle compartments and diminished capillary perfusion. ^1,2,3 Fas ciotomy should theoretically be a logical adjunct to therapy when anticoagula tion or venous thrombectomy is contraindicated or ineffective. Benefits attri buted to compartment decompression have been reported.^2,4 Nevertheless, publicized failures of fasciotomy to reverse the ischemia of phlegmasia cerulea dolens have discouraged its use.^5,1