Shoelace Wound Closure for the Management of Fracture-Related Fasciotomy Wounds

Eid, Abdelsalam; El-Soufy, Mohamed

doi:10.5402/2012/528382

Cited by 15 publications

(12 citation statements)

References 13 publications

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“…(Range3-6). Eid et al [17] carried out similar study and obtained skin closure at an overall average of 4.2 tightening sessions (range 3-7). Ji yong park et al [18] reported 2-6 operations when shoe lace was used as a method of fasciotomy wound closure.…”

Section: Discussionmentioning

confidence: 92%

“…which otherwise could have happened if closure was attempted in single fashion In our study fasciotomy was performed at an average of 15.2 hrs (range 8-24 hrs) following injury. In a study carried out by EId et al [17] fasciotomy was performed at an average of 21.1 hrs (range 12-36 hrs) following injury. Kakagia et al [20] reported closure time was more if fasciotomy was performed 8hrs after injury.…”

Section: Discussionmentioning

confidence: 99%

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Shoe lace technique, a simple and less expensive method for Fasciotomy wound closure following compartment syndrome

Saini¹,

Sharma²,

Shah³

2018

Int. J. Orthop. Sci.

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Introduction: Compartment syndrome is a common and severe medical condition that can lead to ischemia and ultimately tissue loss. The treatment of choice is emergent fasciotomy to lower the compartment pressure. However, closing fasciotomy wound often presents a problem because of edema and skin retraction. As a result, numerous techniques have been devised to optimize wound closure. AIM: To perform fasciotomy wound closure by shoe lace technique which is a type of dermal apposition technique for gradual primary closure of fasciotomy wound. Materials and Methods:The study included 19 patients who presented with compartment syndrome involving either upper or lower extremities due to various causes. Decompression fasciotomy was performed in all the cases to relieve compartment pressure. Shoe lace technique was performed for closure of wound. Patients demographics, location of fasciotomy, time duration between injury and fasciotomy, number of tightening session, time to primary closure, length of hospital stay, need for skin grafts and any complication if occurred during procedure were recorded. Results: Out of 19 patients 15 were males and 4 were females. Average age was 34.8 years. Lower extremity was involved in 14 cases. Fracture was the cause of compartment syndrome in 16 cases. Closure was obtained at an average of 3.5 tightening session. All the fasciotomy wounds were closed within an average of 8.3 days. Average duration of hospital stay was 12.3 days. No major complication was encountered in the study one case reported to have infection at wound site. Conclusion: Shoe lace technique is a simple and economical method for fasciotomy wound closure. It takes less time to closure, does not need a second procedure for closure thus reduces need of nursing care, hospital stay resulting in lower morbidity, healthcare cost and better aesthetic result.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Shoe lace technique, a simple and less expensive method for Fasciotomy wound closure following compartment syndrome

Saini¹,

Sharma²,

Shah³

2018

Int. J. Orthop. Sci.

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“…In a similar study by Eid et al, closure was obtained at an overall average of 4.2 tightening sessions (range 3-7) whereas, Park et al and Cheng et al reported 2-6 sessions for wound approximation. [21][22][23] Marek et al and Chiverton et al suggested obtaining closure in single sitting. 20,24 We achieved wound approximation in 4 tightening sessions which was on par with other studies in literature.…”

Section: Discussionmentioning

confidence: 99%

Comparative study of delayed primary closure by shoelace technique versus conventional secondary suturing method in closure of fasciotomy wounds, done for spreading cellulitis with compartment syndrome

Thrishuli

Kumar

2020

Int Surg J

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Background: Fasciotomy is a standard treatment for acute compartment syndrome. Historically, fasciotomy incisions were usually left open till oedema settles down. In literature, there is a wide range of wound closure techniques published, but none of them is deemed to be the best. In this study, focus is laid on whether delayed primary closure (DPC) by shoelace technique, is as effective as conventional secondary suturing, in closure of fasciotomy wounds, done for spreading cellulitis.Methods: All those patients who met below mentioned inclusion criteria and underwent fasciotomy, were allocated into 2 groups (A and B) where Group A consists of 30 patients undergoing conventional secondary suturing, whereas Group B consists of 30 patients undergoing DPC by shoelace technique for closure of fasciotomy wounds. Parameters such as duration of hospital stay, time taken for complete wound closure, local wound complications, hospital expenses, anaesthesia related complications between the two groups were compared.Results: Patients who underwent DPC for fasciotomy wound closure achieved wound closure ~7 days earlier with 5 days lesser hospital stay than that of those who underwent conventional secondary suturing. Average health care cost of Group B was significantly lower compared to Group A, but there was no statistically significant difference in incidence of wound infections between the two groups.Conclusions: DPC by shoelace technique, takes less time for wound closure and hence the need for nursing care and hospital stay is significantly reduced in comparison to the conventional secondary suturing method.

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“…13 Chiverton et al and Eid et al also utilized suture and catheter for the closure of fasciotomy wounds and got satisfactory results. 14,15 So closure of wounds with soft tissue defects could be done by applying the dermo-traction technique in a better effective way than skin grafting.…”

Section: Discussionmentioning

confidence: 99%

Dermo traction as a solution to major skin defects: a prospective study in a tertiary care hospital of South Odisha

Sahu

Panda

2019

Int J Res Orthop

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Background: Soft tissue loss with exposure of underlying tissue is a challenge to all Orthopedics surgeons. The present prospective study described dermo-traction technique using infant feeding tube or prolene suture as an alternative method for the wound closure.Methods: This prospective study described 30 cases where dermo-traction technique was used for the closure of the wound using infant feeding tube or prolene suture. Study was conducted in Orthopaedics Department of MKCG Medical College, Berhampur from June 2016 to May 2018. Patients requiring skin grafting for their major soft tissue defects or in whom skin grafting or fasciocutaneous flap could not be done were included in study.Results: Out of 30 patients, 2 were lost to follow-up. Average age of study participants was 39.1 years. Male constituted 67.8%. 78.5% of patients had wound in leg, 14.3% in thigh region, rest had on ankle. 82.1% had an open fracture wound, 10.7% had post-operative wound dehiscence and 7.1% soft tissue injury. Average wound healing time was 15.3days with average 5 tightening session of suture. Wounds healed eventually in 26 patients and 2 patients had an infection. Among 26 patients 9 patients had delayed primary and 17 had secondary closure of wound.Conclusions: It can be concluded that gradual closure of the wounds with soft tissue defects can be achieved by applying dermo-traction technique using prolene suture or infant feeding tube with average 15 days of time. So dermo-traction using infant feeding tube or prolene suture is a simple, inexpensive, effective and technically sound alternate solution for closure of wound.

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Shoelace Wound Closure for the Management of Fracture-Related Fasciotomy Wounds

Cited by 15 publications

References 13 publications

Shoe lace technique, a simple and less expensive method for Fasciotomy wound closure following compartment syndrome

Shoe lace technique, a simple and less expensive method for Fasciotomy wound closure following compartment syndrome

Comparative study of delayed primary closure by shoelace technique versus conventional secondary suturing method in closure of fasciotomy wounds, done for spreading cellulitis with compartment syndrome

Dermo traction as a solution to major skin defects: a prospective study in a tertiary care hospital of South Odisha

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