Page 192 - ASOP ROT Study Guide

3.3 The Consequences of Swelling
If swelling is ignored, then it makes the soft tissues "hard" in the short term, and delays healing.
In the long term, swelling may lead to excessive scarring which is probably caused by the
prevention of return to nonnal blood flow during the healing process. The effects of this are
stiffness and loss of function of the affected part, resulting in a delay in the rehabilitation of the
whole patient.
Early treatment of injury is therefore a balance between reducing the effects of the increased blood
supply caused by inflammation, and encouraging the return of normal blood circulation as soon as
possible.
3.4 Compartment Syndrome
One serious effect of injury is related to the natural consequences of acute inflammation and
swelling. This is known as compartment syndrome. This is also described in the module on
Trauma - section 10.5.
When muscles in a compartment are injured they bleed and swell naturally as described above.
Generally the increased volume of the fluid and blood can be accommodated in the compartment
through a modest expansion and a slight increase in pressure. However, if bleeding and swelling
are excessive, the compartment cannot expand to cope because of the fibrous sheath surrounding
it. Pressure in the compartment therefore increases.

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Blood still enters the damaged muscles naturally and, as the resistance to flow builds up, the blood
flow becomes increasingly sluggish. This means that the blood supply to the muscles decreases.
The capillaries in the muscle tissue dilate and the tissues continue to swell. Eventually the pressure