A Simple Solution for Wound Coverage by Skin Stretching

Ismavel, Ravichand; Samuel, Sumant; Boopalan, P.R.J.V.C.; Chittaranjan, Samuel

doi:10.1097/bot.0b013e318206f556

Cited by 19 publications

(17 citation statements)

References 11 publications

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“…Based on the viscoelastic properties of normal skin, a skin-stretching device can use constant traction and maintain approximation to facilitate closing large wounds without applying tension. Many surgical designs 7–11 are available for treating large wound closures, but most special devices based on these designs require additional equipment and materials to achieve gradual wound closure. Using skin-traction beyond this level was reported by Escalera, 12 who attached rubber bands to staples applied to the skin edges.…”

Section: Discussionmentioning

confidence: 99%

Simple Skin-Stretching Device in Assisted Tension-Free Wound Closure

Cheng

Lee

Hsu

et al. 2017

Annals of Plastic Surgery

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Background Numerous conventional wound reconstruction methods such as wound undermining with direct suture, skin graft, and flap surgery can be used to treat large wounds. The adequate undermining of the skin flaps of a wound is a commonly used technique for achieving the closure of large tension wounds; however, the use of tension to approximate and suture the skin flaps can cause ischemic marginal necrosis. The purpose of this study is to use elastic rubber bands to relieve the tension of direct wound closure for simultaneously minimizing the risks of wound dehiscence and wound edge ischemia that lead to necrosis. Materials and Methods This retrospective study was conducted to evaluate our clinical experiences with 22 large wounds, which involved performing primary closures under a considerable amount of tension by using elastic rubber bands in a skin-stretching technique following a wide undermining procedure. Assessment of the results entailed complete wound healing and related complications. Results All 22 wounds in our study showed fair to good results except for one. The mean success rate was approximately 95.45%. Conclusion The simple skin-stretching design enabled tension-free skin closure, which pulled the bilateral undermining skin flaps as bilateral fasciocutaneous advancement flaps. The skin-stretching technique was generally successful.

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Section: Discussionmentioning

confidence: 99%

Simple Skin-Stretching Device in Assisted Tension-Free Wound Closure

Cheng

Lee

Hsu

et al. 2017

Annals of Plastic Surgery

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“…Wound dehiscence, wound edge necrosis, and skin tears are the most reported complications [ 14 , 30 , 31 ] (Table 2 ). Studies showed that the wound approximation technique was associated with relatively high wound dehiscence (20–33%) [ 8 , 30 , 31 ]. However, no patient developed wound dehiscence in this small series.…”

Section: Discussionmentioning

confidence: 99%

A novel skin-stretching device for closing large skin-soft tissue defects after soft tissue sarcoma resection

Shao

et al. 2020

World J Surg Onc

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Background Closure of large skin-soft tissue defects following soft tissue sarcoma (STS) resection has been a great challenge. The objective of this study was to evaluate the effectiveness of a novel, simple, and cheap skin-stretching device (bidirectional regulation-hook skin closure system, BHS) for closing large skin-soft tissue defects resulting from the removal of STS and the complications associated with the use of the BHS. Methods From January 2017 to September 2018, 25 patients with STS underwent BHS therapy after tumor resection. BHS was used for two main clinical applications: securing wound closure after high-tension suture closure and delayed wound closure. We described a detailed reconstruction procedure regarding this therapy. Wound closure and complications associated with BHS therapy were recorded. We also analyzed tumor recurrence and metastases. Results All patients were observed for 16–36 months with an average follow-up of 25.6 months. During the follow-up period, no significant functional restriction was observed and the final scar was aesthetically acceptable. Superficial wound infection occurred in six patients, wound edge ischemia in two patients, and small skin tears in two patients. Two patients developed pulmonary metastasis, two patients had a local recurrence, and one patient died of pulmonary metastasis. Conclusions BHS therapy can effectively close large skin-soft tissue defects following STS resection and obtain acceptable functional results, without severe complications. However, larger studies are required to further evaluate the effectiveness, indications, and complications of BHS therapy.

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“…The biggest problem of this technique was the need of daily returns to the operating room, which made treatment difficult. Since then, the elastic band has been used in intervention of various types of wounds, including compartmental syndrome 10,11 , extensive fasciotomy wounds [12][13][14][15] , open fractures 16 , injuries from burns 17 and large wounds of the body wall 15,18 .…”

Section: Discussion Discussion Discussion Discussionmentioning

confidence: 99%

“…The use of elastic bands to traction the wound edges is an effective resource in the treatment of large wounds of the body wall [9][10][11][12][13][14][15][16][17][18] . This closure occurs by skin stretching, using the viscoelastic properties of the skin 12,13,16,18 .…”

Section: Discussion Discussion Discussion Discussionmentioning

confidence: 99%