A fasciotomy is a surgical procedure in which an outlet is created in the fascia to relieve pressure. This procedure may be performed on an emergency basis, or scheduled to deal with an ongoing medical problem. It is usually performed by a general surgeon or foot specialist, depending on the areas of the body where the fasciotomy is required. Recovery time after the surgery varies, depending on that location of the procedure and other health factors in the patient's life. The healthier the patient is at the time of the procedure, the shorter the healing time.
Fascia is part of the connective tissue in the musculoskeletal system which acts as a sort of envelope to protect muscles and other structures while providing support. When pressure builds up under the fascia, it can lead to serious health problems, such as an interruption in the supply of blood to a limb. In plantar fasciitis, a chronic inflammatory condition of the foot, swelling occurs as a consequence of the inflammation. Swelling can also happen anywhere in the body as a result of inflammation, infection, and crush injuries.
A surgeon will recommend a fasciotomy when it becomes evident that the pressure building under the fascia is high enough that the patient is at risk of complications. Using a local anesthetic, the surgeon will numb the area and make an incision to open up a hole in the fascia to relieve the pressure. As the surgical site heals, tissue will grow across the hole, making the fascia slightly longer and reducing the risk of a dangerous buildup of pressure in the future.
Sometimes, a fasciotomy may be performed while a patient is under a general anesthetic. This may be done when the procedure is performed as part of a larger surgery, or in the case of a patient with severe burns who may be in extreme pain. The general anesthetic helps to manage pain, and also provides opportunities to perform other procedures such as skin grafts on the burned areas.
For plantar fasciitis, it is possible to perform an endoscopic fasciotomy, with the surgeon making two small slits to introduce a cutting tool and a camera. In other cases, it will be necessary to make a longer incision. Recovery from an open fasciotomy in which a large incision needs to be made usually takes longer, as the site of the incision needs time to heal before the patient resumes normal activities.