Prevention of well-leg compartment syndrome following lengthy medical operations in the lithotomy position

Abstract Purpose Compartment syndrome that occurs after lengthy surgery in the lithotomy position is known as well-leg compartment syndrome (WLCS). WLCS has serious consequences for patients, including amyotrophic renal failure, limb loss, and sometimes, even death. This study aimed to identify effective preventive measures against WLCS using a retrospective cohort study of 1951 patients (985 and 966 in the prevention and control groups, respectively). Material and methods The following preventive interventions were analyzed: 1) changing from the lithotomy position to the open-leg position, 2) removing lower leg pressure caused by the lithotomy position, 3) limiting leg elevation based on the height of the right atrium, 4) horizontally repositioning the operating table every 3 hours, and 5) decompressing the contact area of the lower leg in the lithotomy position during operation. Results Eight cases of WLCS occurred in the control group, while no WLCS occurred in the prevention group. Conclusions These findings suggest that the five interventions assessed can prevent the development of WLCS.