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

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.	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.	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.	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.	倪国骅, 吴学建, 张德洪, 等. 皮肤弹性牵张法闭合小腿骨筋膜室高压减张切口. 中国矫形外科杂志, 2016, 24(4): 382-384.
12.	秦泗河, 李刚. Ilizarov 技术骨科应用进展. 北京: 人民军医出版社, 2014: 33.
13.	秦泗河. Ilizarov 技术概述. 中华骨科杂志, 2006, 26(9): 642-645.
14.	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.
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.	蒋朔, 陈莉, 李永忠, 等. 皮肤外扩张器修复巨大创面二例. 中华整形外杂志, 2016, 32(2): 151-152.

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. 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. 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. 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. 倪国骅, 吴学建, 张德洪, 等. 皮肤弹性牵张法闭合小腿骨筋膜室高压减张切口. 中国矫形外科杂志, 2016, 24(4): 382-384.
12. 秦泗河, 李刚. Ilizarov 技术骨科应用进展. 北京: 人民军医出版社, 2014: 33.
13. 秦泗河. Ilizarov 技术概述. 中华骨科杂志, 2006, 26(9): 642-645.
14. 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.
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. 蒋朔, 陈莉, 李永忠, 等. 皮肤外扩张器修复巨大创面二例. 中华整形外杂志, 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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