Oner KILINC, Fatih GUNAYDIN, Idris DEMIRTAS, Bulent SAKARYA
Annals of Medical Research - 2026;33(7):347-353
Aim: February 6, 2023 Kahramanmaras earthquakes were among the most devastating disasters in Türkiye, causing numerous musculoskeletal injuries. This study evaluated orthopedic surgeons' experiences with fasciotomy in disaster zones, focusing on surgical practices, complication rates, challenges, and the adequacy of training. Materials and Methods: Between March-April 2023, an 18-item online survey was conducted among orthopedic surgeons serving in the earthquake-affected region. A total of 114 surgeons participated. The questionnaire covered demographics, surgical experience, fasciotomy techniques, complications, and training perceptions. Subgroup analyses were performed by experience level, surgical setting, incision preference, and prior fasciotomy exposure. Results: Fasciotomies were mainly performed in the operating room (74%; n=85), followed by the emergency department (12%; n=14), field hospitals (7%; n=8), intensive care units (4%; n=5), and temporary areas (3%; n=3). For leg fasciotomies, double incisions were preferred in 81% (n=92) and single incisions in 16% (n=18). For forearm fasciotomies, volar incisions were used in 74% (n=84), and combined volar+dorsal incisions were used in 26% (n=30). The overall complication rate was 43% (n=49); the most common complications were bleeding (16%; n=18) and wound problems (12%; n=14). Inadequately decompressed compartments were reported in 86% of cases (n=98). Complications were more frequent among surgeons with 1-5 years' experience (58%; n=18) compared with those with >10 years' experience (35%; n=17) (p=0.03), and were more frequent when procedures performed outside the operating room (55%; n=16) than within it (29%; n=25) (p=0.01). Surgeons with prior fasciotomy experience reported higher confidence (76%; n=73) than those without (41%; n=7) (p<0.01). Conclusion: The fasciotomy experiences of orthopedic surgeons during the Kahramanmaraş earthquake revealed deficiencies in standardization and competency in disaster surgery. Outcomes depended on the surgeon's experience and on the surgical conditions. Strengthening disaster preparedness requires structured training, simulation-based exercises, national and international guidelines.
