The fascia is divided along the length of the compartment to release pressure within. The skin is also left open for several days to weeks because some post-ischemic swelling occurs after surgical decompression. Consider bicarbonate or acetezolamide to alkalinize the urine to help prevent myoglobinuria. This occurs after reperfusion of the damaged tissue, where the myoglobin in the muscle is released and precipitates in the renal tubules, primarily in acidic urine, leading towards renal failure. Irreversible tissue death can occur in 4-12 hours depending on the tissue type and the compartmental pressure.
Permanent disabilities result from undiagnosed compartment syndromes.
Ischemic Contractures - After prolonged ischemia, tissue contractures that can be crippling can develop. This was well described by Volkmann. Amputation - Sometimes tissue is beyond repair and the only measure to prevent gangrene and possibly death is amputation. Myoglobinuria - This primarily occurs after reperfusion of the damaged tissue following fasciotomy, where the myoglobin in the muscle is released and precipitates in the renal tubules, primarily in acidic urine, possibly leading to renal failure. Prevention includes generous fluids and alkalization of the urine.