Application of modified adjustable skin stretching and secure wound-closure system in repairing of skin and soft tissue defect_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

DONG Qiqiang , GU Guojun , WANG Lijun ,  FU Keda , XIE Shuqiang , ZHANG Songjian , ZHANG Huafeng , WU Zhaosen

The Third Department of Surgery, Zhengzhou Renji Hospital, Zhengzhou Henan, 450000, P.R.China;

Corresponding?author：

FU Keda, Email: 420792009@qq.com

Keywords：

Skin defect; skin stretching and secure wound-closure system; modified method; repair; skin-stretching expansion

DOI：

10.7507/1002-1892.201707103

Video：

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Objective To investigate the application of modified adjustable skin stretching and secure wound-closure system in repairing of skin and soft tissue defect. Methods Between March 2016 and April 2017, 21 cases of skin and soft tissue defects were repaired with the modified adjustable skin stretching and secure wound-closure system (the size of regulating pressure and the times of adjustment were determined according to the color, temperature, capillary response, and swelling degree of the skin edge). There were 11 males and 10 females, with an average age of 49.2 years (range, 21-67 years). Among them, 1 case was the residual wound after amputation of leg; 18 cases were the wounds after traumatic injury operation, including 4 cases in the lower leg, 3 cases in the knee joint, 7 cases in the upper limb, and 4 cases in the foot; and 2 cases were diabetic feet. The skin defect area ranged from 4.0 cm×2.5 cm to 21.0 cm×10.0 cm. Results Skin defect wounds closed directly in one stage in 4 cases; 12 cases were closed after continuously stretching for 5-14 days (mean, 10 days); 5 cases were reduced to less than one-half area, and the wound healed after the second skin grafting or flap repairing. All the 21 patients were followed up 3-12 months (mean, 5.2 months). The wound was linear healing with small scar, and no invasive margin, poor blood flow, necrosis, and poor sensory function happened. Conclusion The modified adjustable skin stretching and secure wound-closure system can reduce the skin and soft tissue defects or close the wound directly, and even replace the skin graft and skin flap repairing. It was a good method for the treatment of skin and soft tissue defect.

Citation： DONG Qiqiang, GU Guojun, WANG Lijun, FU Keda, XIE Shuqiang, ZHANG Songjian, ZHANG Huafeng, WU Zhaosen. Application of modified adjustable skin stretching and secure wound-closure system in repairing of skin and soft tissue defect. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(12): 1481-1484. doi: 10.7507/1002-1892.201707103 Copy

1.	苑博, 梁海東, 王壽宇, 等. 新型拉桿式即時皮膚擴張器治療肢體皮膚缺損. 中國矯形外科雜志, 2017, 25(4): 371-373.
2.	王葉武, 金玉梅, 張勇, 等. 自制硅膠線皮膚牽張技術在皮膚軟組織缺損中的臨床效果. 實用骨科雜志, 2016, 22(11): 1048-1051.
3.	Liang MD, Briggs P, Heckler FR, et al. Presuturing-a new technique for closing large skin defects: clinical and experimental studies. Plast Reconstr Surg, 1988, 81(5): 694-702.
4.	Blomqvist G, Steenfos H. A new partly external device for extension of skin before excision of skin defects. Scand J Plast Reconstr Surg Hand Surg, 1993, 27(3): 179-182.
5.	吳翔, 楊志華, 徐曉華. 新型皮膚牽張器在壓瘡創面治療中的應用. 浙江創傷外科, 2017, 22(1): 65-66.
6.	朱占永, 趙月強, 李愛林, 等. TopClosure?皮膚牽張閉合器在胸部大面積皮膚缺損創面修復中的臨床應用. 臨床外科雜志, 2017, 25(8): 630-633.
7.	趙月強, 呂朝陽, 朱占永, 等. 皮膚牽張聯合可調式負壓吸引裝置治療難愈性褥瘡. 臨床外科雜志, 2015, 23(11): 849-851.
8.	張德, 丘宏偉, 黃耀斌, 等. 皮膚伸展術在修復肢體創傷性皮膚缺損中的應用. 中華創傷雜志, 2002, 18(3): 152-154.
9.	何龍, 李祥, 曾利, 等. 皮膚牽張閉合器在四肢創面修復中的應用. 中國骨與關節損傷雜志, 2016, 31(11): 1171-1173.
10.	楊頗, 宋開芳, 周家順, 等. 超聲清創技術聯合皮膚持續性牽張修復難愈性感染性創面 15 例. 中國感染與化療雜志, 2017, 17(4): 353-355.
11.	楊俊興, 陳建發, 張華, 等. " ■”形克氏針皮膚減張術治療四肢軟組織缺損. 中醫正骨, 2016, 28(4): 42-43, 46.
12.	池凱, 毋磊, 陳龍金, 等. 評價四肢創面修復中應用皮膚牽張閉合器的效果及預后. 中國醫療美容, 2017, 7(3): 35-37.
13.	黨正杰, 張寶泉, 王守峰, 等. 實用新型皮膚牽拉器的臨床應用. 中國組織工程研究, 2015, 19(43): 7047-7052.
14.	陳約東, 蔣繼亮, 孫中洋, 等. 新型皮膚牽伸器在糖尿病患者下肢皮膚軟組織缺損創面中的應用. 中國臨床研究, 2017, 30(9): 1258-1260.
15.	曲家富, 杜曉健, 曹立海, 等. 應用皮膚牽張帶治療各類皮膚軟組織缺損 26 例. 中國骨與關節損傷雜志, 2006, 21(8): 671-672.
16.	羅志勇. 皮膚牽張閉合器在治療褥瘡創面中的體會. 中國現代藥物應用, 2013, 7(19): 51-52.
17.	王晉軍, 張娟子, 王兆偉, 等. 祛腐清筋聯合皮膚牽張閉合系統治療糖尿病足壞疽. 中國中西醫結合外科雜志, 2015, 21(6): 604-606.
18.	臧建成, 秦泗河. 從 Wolff 定律和 Ilizarov 張力-應力法則到骨科自然重建理念. 中國骨傷, 2013, 26(4): 287-290.

1. 苑博, 梁海東, 王壽宇, 等. 新型拉桿式即時皮膚擴張器治療肢體皮膚缺損. 中國矯形外科雜志, 2017, 25(4): 371-373.
2. 王葉武, 金玉梅, 張勇, 等. 自制硅膠線皮膚牽張技術在皮膚軟組織缺損中的臨床效果. 實用骨科雜志, 2016, 22(11): 1048-1051.
3. Liang MD, Briggs P, Heckler FR, et al. Presuturing-a new technique for closing large skin defects: clinical and experimental studies. Plast Reconstr Surg, 1988, 81(5): 694-702.
4. Blomqvist G, Steenfos H. A new partly external device for extension of skin before excision of skin defects. Scand J Plast Reconstr Surg Hand Surg, 1993, 27(3): 179-182.
5. 吳翔, 楊志華, 徐曉華. 新型皮膚牽張器在壓瘡創面治療中的應用. 浙江創傷外科, 2017, 22(1): 65-66.
6. 朱占永, 趙月強, 李愛林, 等. TopClosure?皮膚牽張閉合器在胸部大面積皮膚缺損創面修復中的臨床應用. 臨床外科雜志, 2017, 25(8): 630-633.
7. 趙月強, 呂朝陽, 朱占永, 等. 皮膚牽張聯合可調式負壓吸引裝置治療難愈性褥瘡. 臨床外科雜志, 2015, 23(11): 849-851.
8. 張德, 丘宏偉, 黃耀斌, 等. 皮膚伸展術在修復肢體創傷性皮膚缺損中的應用. 中華創傷雜志, 2002, 18(3): 152-154.
9. 何龍, 李祥, 曾利, 等. 皮膚牽張閉合器在四肢創面修復中的應用. 中國骨與關節損傷雜志, 2016, 31(11): 1171-1173.
10. 楊頗, 宋開芳, 周家順, 等. 超聲清創技術聯合皮膚持續性牽張修復難愈性感染性創面 15 例. 中國感染與化療雜志, 2017, 17(4): 353-355.
11. 楊俊興, 陳建發, 張華, 等. " ■”形克氏針皮膚減張術治療四肢軟組織缺損. 中醫正骨, 2016, 28(4): 42-43, 46.
12. 池凱, 毋磊, 陳龍金, 等. 評價四肢創面修復中應用皮膚牽張閉合器的效果及預后. 中國醫療美容, 2017, 7(3): 35-37.
13. 黨正杰, 張寶泉, 王守峰, 等. 實用新型皮膚牽拉器的臨床應用. 中國組織工程研究, 2015, 19(43): 7047-7052.
14. 陳約東, 蔣繼亮, 孫中洋, 等. 新型皮膚牽伸器在糖尿病患者下肢皮膚軟組織缺損創面中的應用. 中國臨床研究, 2017, 30(9): 1258-1260.
15. 曲家富, 杜曉健, 曹立海, 等. 應用皮膚牽張帶治療各類皮膚軟組織缺損 26 例. 中國骨與關節損傷雜志, 2006, 21(8): 671-672.
16. 羅志勇. 皮膚牽張閉合器在治療褥瘡創面中的體會. 中國現代藥物應用, 2013, 7(19): 51-52.
17. 王晉軍, 張娟子, 王兆偉, 等. 祛腐清筋聯合皮膚牽張閉合系統治療糖尿病足壞疽. 中國中西醫結合外科雜志, 2015, 21(6): 604-606.
18. 臧建成, 秦泗河. 從 Wolff 定律和 Ilizarov 張力-應力法則到骨科自然重建理念. 中國骨傷, 2013, 26(4): 287-290.

Chinese Journal of Reparative and Reconstructive Surgery

Application of modified adjustable skin stretching and secure wound-closure system in repairing of skin and soft tissue defect

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