Cartography and Topographic Mapping: The Historical Basis for the Standardization of Anatomical Analysis and Surgical Mark-Making to Improve Outcomes in Body Contouring.

SUMMARY: Maps have been used for thousands of years to guide and advance mankind's interests. Recently, cartography has grown exponentially into standardized, densely layered systems, facilitating countless functions that use complex algorithms and multifactorial data. Surgeons have successfully addressed bodily concerns for centuries, aided by consistency of human anatomy, physiologic responses to disease, and patterns of disease. However, body contouring techniques alter the much more inconsistent surface anatomy of stretched or aged skin and highly variable subcutaneous fullness. To date, no consistent strategy has been proposed to analyze, map, and alter human shape in a standardized fashion; however, well-established cartographic methods for topographic mapping can be logically adapted to meet surgical needs. Quantification of results, valid and meaningful comparison of techniques, and anatomical discovery could all be achieved by adopting cartographic methods. As anatomists and scientists, surgeons constantly seek logical and reproducible methods to improve patient outcomes. In this article, the authors present a technique derived from topographic mapping, applied directly to the surface of the human body, reflecting the actual underlying anatomy, to guide both elective and reconstructive procedures. The method provides logical and quantifiable methods for (1) the analysis of anatomy, (2) data-driven planning of surgical care, and (3) a consistent operative implementation-so that each patient can receive individualized, anatomically based procedures. Use of well-established mapping strategies would also promote interdisciplinary collaboration, permit adaptation of software to analyze volume and shape, and improve patient outcomes through quantification of change and meaningful comparisons of procedural options.

Single incision fasciotomy for acute compartment syndrome of the leg: A systematic review of the literature.

Purpose: To review published literature assessing clinical outcomes and complication rates of single incision fasciotomy in fractures of the lower leg. Methods: We searched PubMed and EMBASE for articles published through July 5, 2021, using the terms "single incision fasciotomy", "acute compartment syndrome of the limbs", "compartment syndrome fasciotomy", and "(compartment syndrome fasciotomy) AND (incision)". The inclusion criteria were studies of Level I to IV evidence in English, published in 1970 or later, involving human subjects, reporting clinical outcomes of single incision fasciotomy performed in cases of acute compartment syndrome in lower leg fractures, including at least 1 patient. Results: Among the 3040 combined total results, 11 primary studies met our inclusion criteria. Adequate and safe compartment release was achieved with single-incision technique. No significant difference was found in terms of complications such as infection and non-union. Conclusions: The comparative efficacy and safety of single-incision fasciotomy is relatively equal to the two-incision techniques when evaluated in the literature. However, double-incision fasciotomy remains the predominant surgical technique, widely preferred by surgeons due to the familiarity with the technique and ease of full compartment release. In addition to the actual fasciotomy procedure, data suggests that operative timing, closure and fixation techniques can significantly impact patient outcomes. These findings may be used to guide the orthopedic community when determining the optimal incision-type to use in acute compartment syndrome emergencies for lower-extremity fracture cases in conjunction with closure and fixation techniques.