'Well-leg' compartment syndrome associated with gynaecological surgery: a perioperative risk-reduction protocol and checklist

BJOG. 2021 Aug;128(9):1517-1525. doi: 10.1111/1471-0528.16749. Epub 2021 Jun 7.


'Well-leg' compartment syndrome (WLCS) is an uncommon, but potentially devastating, complication associated with prolonged patient positioning for abdomino-pelvic surgery. Gynaecologists, anaesthetists and the wider theatre team share a responsibility to minimise the risk of this highly morbid, and even fatal, postoperative complication. This article provides an overview of WLCS related to gynaecological surgery - raising awareness amongst gynaecologists and highlighting the time-critical nature of diagnosis and management. Given the potential litiginous nature of this complication, we also present a perioperative checklist and risk-reduction protocol to suggest a standardised approach to prevention and relevant documentation. TWEETABLE ABSTRACT: Gynaecologists share a responsibility to minimise the risk of postoperative 'well-leg' compartment syndrome.

Keywords: Gynaecology; patient safety; risk reduction; surgery; ‘well-leg’ compartment syndrome.

Publication types

  • Review

MeSH terms

  • Compartment Syndromes / diagnosis
  • Compartment Syndromes / etiology*
  • Compartment Syndromes / therapy
  • Female
  • Gynecologic Surgical Procedures / adverse effects*
  • Humans
  • Leg / blood supply*
  • Patient Positioning / adverse effects*
  • Postoperative Complications / diagnosis
  • Postoperative Complications / etiology
  • Postoperative Complications / therapy
  • Risk Factors