MemberAugust 11, 2015 at 12:56 am
Fascia Tightening ??
Thank you for taking the time to respond! I am very grateful. This information about the expertise of a hand transplant surgeon is very valuable and I will follow up on it.
Your other comments are also interesting. My current hand surgeon comes from an orthopedics background (although he has significant expertise in compartment syndromes.) It has only recently occurred to me to see a hand specialist that also has training in plastics/reconstruction…and I have appointments scheduled in upcoming weeks/months.
Your comment regarding the possible complication of a compartment syndrome has been discussed. My hand surgeon said he would monitor the compartment pressures intra-operatively and then also monitor them very closely in the immediate post-op period. He said it’s possible to continuously monitor. I recognize this is a significant risk. In fact, I have also seen publications in the medical literature that argue against “fasciorrhaphy” in cases of a hernia in the lower leg, and instead recommend a fasciotomy – b/c of risk of compartment syndrome.
I’ll take into account your comment regarding damage to veins in skin. However, I can point to a number of things in my clinical picture that lend itself against this…I just don’t want to make this post too long.
At present, the pressure in the volar compartment is very low — below normal range. Much of venous return is based on pressure gradients. The goal of a fascia tightening surgery would be to bring pressure back into normal range, 4 to 10 mmHG at rest.
My main question is still … is it possible to tighten the fascia around the forearm muscles ?? Are there techniques regularly used in hernia repair that could also be used in the forearm? My surgeon says that anytime he has tried to stitch fascia that it just shreds apart. Yet, I seem to be reading about all these fascia repairs … it even seems like cosmetic tummy tuck procedures rely on “fascia tightening.”
Can it be done? Can someone please explain, or point me in the direction of relevant medical literature?
Obviously, I’m desperate. The pain at night is severe. There is something about “sleepiness” that puts this over-the-top for me. And during the daytime, I find caffeine to be very helpful for symptoms.
Much thanks … and hope to hear something back.