Application of delayed skin-stretching device in treatment of skin and soft tissue defects_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

SONG Wenji , YUAN Bo , ZHAO Zhengnan , TONG Zhihong ,  LIANG Haidong

Department of Hand and Foot Surgery, the Second Hospital of Dalian Medical University, Dalian Liaoning, 116023, P.R.China;

Corresponding?author：

LIANG Haidong, Email: johnlhd@163.com

Keywords：

Skin and soft tissue defect; delayed skin-stretching device; skin stretching

DOI：

10.7507/1002-1892.201804050

Video：

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ObjectiveTo summarize the effectiveness of delayed skin-stretching device in treatment of skin and soft tissue defects.MethodsBetween December 2014 and December 2016, 10 cases of skin and soft tissue defects were treated with delayed skin-stretching device. There were 6 males and 4 females with an average age of 53 years (range, 42-64 years). The skin and soft tissue defects were caused by acute trauma in 6 cases. The incision could not be closed directly after making incisions because of osseous fascia syndrome in 3 cases. The skin soft tissue defect caused after huge carbuncle incision and drainage in 1 case. The defect located at thigh in 4 cases, lower leg in 3 cases, upper arm in 2 cases, back in 1 case. The defect area ranged from 10 cm×4 cm to 22 cm×12 cm. Pinch test was performed on the wound margin, which confirmed that the wound could not be closed directly.ResultsTension blisters were found in 3 cases during traction, and no complications such as impaired blood circulation or skin necrosis occurred in all cases. Skin defects closed directly after continuously stretching for 7-18 days. No skin graft or free flap repair was performed in all patients. The wound healed well after operation. All the 10 patients were followed up 5-8 months (mean, 6.5 months). There was no necrosis around the wound margin and the scar was linear. The sensation and function were not affected.ConclusionDelayed skin-stretching device is an effective method to treat skin and soft tissue defects, which has the advantages of simple operation, lower risk of operation, less complications, and reliable effectiveness.

Citation： SONG Wenji, YUAN Bo, ZHAO Zhengnan, TONG Zhihong, LIANG Haidong. Application of delayed skin-stretching device in treatment of skin and soft tissue defects. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(10): 1281-1285. doi: 10.7507/1002-1892.201804050 Copy

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11.	倪國驊, 吳學建, 張德洪, 等. 皮膚彈性牽張法閉合小腿骨筋膜室高壓減張切口. 中國矯形外科雜志, 2016, 24(4): 382-384.
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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. Barrer S, Pavlides CA, Matsumoto T. Ideal iaparotomy closure: comparison of retention sutures with new retention bridging devices. Am Surg, 1976, 42(8): 582-584.
3. Al-Mubarak L, Al-Haddab M. Cutaneous wound closure materials: an overview and update. J Cutan Aqesthetie Surg, 2013, 6(4): 178-188.
4. Katzengol R, Topaz M, Gefen A. Tissue loads applied by a novel medical device for closing large wound. J Tissue Viability, 2016, 25(1): 32-40.
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. Vanlaningham CJ, Schaller TM, Wise C. Skeletal versus skin traction before definitive management of pediatricfemur fractures: a comparison of patient narcotic requirements. J Pediatr Orthop, 2009, 29(6): 609-611.
9. Rosen JE, Chen FS, Hiebert R, et al. Efficacy of preoperative skin traction in hip fracture patients: a prospective, randomized study. J Orthop Trauma, 2001, 15(2): 81-85.
10. Ismavel R, Sumant S, Boopalan PR, et al. A simple solution for wound coverage by skin stretching. J Orthop Trauma, 2011, 25(3): 127-132.
11. 倪國驊, 吳學建, 張德洪, 等. 皮膚彈性牽張法閉合小腿骨筋膜室高壓減張切口. 中國矯形外科雜志, 2016, 24(4): 382-384.
12. 秦泗河, 李剛. Ilizarov 技術骨科應用進展. 北京: 人民軍醫出版社, 2014: 33.
13. 秦泗河. Ilizarov 技術概述. 中華骨科雜志, 2006, 26(9): 642-645.
14. 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.
15. Topaz M, Carmel NN, Topaz G, et al. Stress-relaxation and tension relief system for immediate primary closure of large and huge soft tissue defects: an old-new concept: new concept for direct closure of large defects. Medicine (Baltimore), 2014, 93(28): e234.
16. Topaz M, Carmel NN, Topaz G, et al. A substitute for skin grafts, flaps, or internal tissue expanders in scalp defects following tumor ablative surgery. J Drugs Dermatol, 2014, 13(1): 48-55.
17. 蔣朔, 陳莉, 李永忠, 等. 皮膚外擴張器修復巨大創面二例. 中華整形外雜志, 2016, 32(2): 151-152.

Chinese Journal of Reparative and Reconstructive Surgery

Application of delayed skin-stretching device in treatment of skin and soft tissue defects

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