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

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2.	王叶武, 金玉梅, 张勇, 等. 自制硅胶线皮肤牵张技术在皮肤软组织缺损中的临床效果. 实用骨科杂志, 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.	吴翔, 杨志华, 徐晓华. 新型皮肤牵张器在压疮创面治疗中的应用. 浙江创伤外科, 2017, 22(1): 65-66.
6.	朱占永, 赵月强, 李爱林, 等. TopClosure®皮肤牵张闭合器在胸部大面积皮肤缺损创面修复中的临床应用. 临床外科杂志, 2017, 25(8): 630-633.
7.	赵月强, 吕朝阳, 朱占永, 等. 皮肤牵张联合可调式负压吸引装置治疗难愈性褥疮. 临床外科杂志, 2015, 23(11): 849-851.
8.	张德, 丘宏伟, 黄耀斌, 等. 皮肤伸展术在修复肢体创伤性皮肤缺损中的应用. 中华创伤杂志, 2002, 18(3): 152-154.
9.	何龙, 李祥, 曾利, 等. 皮肤牵张闭合器在四肢创面修复中的应用. 中国骨与关节损伤杂志, 2016, 31(11): 1171-1173.
10.	杨颇, 宋开芳, 周家顺, 等. 超声清创技术联合皮肤持续性牵张修复难愈性感染性创面 15 例. 中国感染与化疗杂志, 2017, 17(4): 353-355.
11.	杨俊兴, 陈建发, 张华, 等. " ■”形克氏针皮肤减张术治疗四肢软组织缺损. 中医正骨, 2016, 28(4): 42-43, 46.
12.	池凯, 毋磊, 陈龙金, 等. 评价四肢创面修复中应用皮肤牵张闭合器的效果及预后. 中国医疗美容, 2017, 7(3): 35-37.
13.	党正杰, 张宝泉, 王守峰, 等. 实用新型皮肤牵拉器的临床应用. 中国组织工程研究, 2015, 19(43): 7047-7052.
14.	陈约东, 蒋继亮, 孙中洋, 等. 新型皮肤牵伸器在糖尿病患者下肢皮肤软组织缺损创面中的应用. 中国临床研究, 2017, 30(9): 1258-1260.
15.	曲家富, 杜晓健, 曹立海, 等. 应用皮肤牵张带治疗各类皮肤软组织缺损 26 例. 中国骨与关节损伤杂志, 2006, 21(8): 671-672.
16.	罗志勇. 皮肤牵张闭合器在治疗褥疮创面中的体会. 中国现代药物应用, 2013, 7(19): 51-52.
17.	王晋军, 张娟子, 王兆伟, 等. 祛腐清筋联合皮肤牵张闭合系统治疗糖尿病足坏疽. 中国中西医结合外科杂志, 2015, 21(6): 604-606.
18.	臧建成, 秦泗河. 从 Wolff 定律和 Ilizarov 张力-应力法则到骨科自然重建理念. 中国骨伤, 2013, 26(4): 287-290.

1. 苑博, 梁海东, 王寿宇, 等. 新型拉杆式即时皮肤扩张器治疗肢体皮肤缺损. 中国矫形外科杂志, 2017, 25(4): 371-373.
2. 王叶武, 金玉梅, 张勇, 等. 自制硅胶线皮肤牵张技术在皮肤软组织缺损中的临床效果. 实用骨科杂志, 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. 吴翔, 杨志华, 徐晓华. 新型皮肤牵张器在压疮创面治疗中的应用. 浙江创伤外科, 2017, 22(1): 65-66.
6. 朱占永, 赵月强, 李爱林, 等. TopClosure®皮肤牵张闭合器在胸部大面积皮肤缺损创面修复中的临床应用. 临床外科杂志, 2017, 25(8): 630-633.
7. 赵月强, 吕朝阳, 朱占永, 等. 皮肤牵张联合可调式负压吸引装置治疗难愈性褥疮. 临床外科杂志, 2015, 23(11): 849-851.
8. 张德, 丘宏伟, 黄耀斌, 等. 皮肤伸展术在修复肢体创伤性皮肤缺损中的应用. 中华创伤杂志, 2002, 18(3): 152-154.
9. 何龙, 李祥, 曾利, 等. 皮肤牵张闭合器在四肢创面修复中的应用. 中国骨与关节损伤杂志, 2016, 31(11): 1171-1173.
10. 杨颇, 宋开芳, 周家顺, 等. 超声清创技术联合皮肤持续性牵张修复难愈性感染性创面 15 例. 中国感染与化疗杂志, 2017, 17(4): 353-355.
11. 杨俊兴, 陈建发, 张华, 等. " ■”形克氏针皮肤减张术治疗四肢软组织缺损. 中医正骨, 2016, 28(4): 42-43, 46.
12. 池凯, 毋磊, 陈龙金, 等. 评价四肢创面修复中应用皮肤牵张闭合器的效果及预后. 中国医疗美容, 2017, 7(3): 35-37.
13. 党正杰, 张宝泉, 王守峰, 等. 实用新型皮肤牵拉器的临床应用. 中国组织工程研究, 2015, 19(43): 7047-7052.
14. 陈约东, 蒋继亮, 孙中洋, 等. 新型皮肤牵伸器在糖尿病患者下肢皮肤软组织缺损创面中的应用. 中国临床研究, 2017, 30(9): 1258-1260.
15. 曲家富, 杜晓健, 曹立海, 等. 应用皮肤牵张带治疗各类皮肤软组织缺损 26 例. 中国骨与关节损伤杂志, 2006, 21(8): 671-672.
16. 罗志勇. 皮肤牵张闭合器在治疗褥疮创面中的体会. 中国现代药物应用, 2013, 7(19): 51-52.
17. 王晋军, 张娟子, 王兆伟, 等. 祛腐清筋联合皮肤牵张闭合系统治疗糖尿病足坏疽. 中国中西医结合外科杂志, 2015, 21(6): 604-606.
18. 臧建成, 秦泗河. 从 Wolff 定律和 Ilizarov 张力-应力法则到骨科自然重建理念. 中国骨伤, 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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