Continuous External Tissue Expansion Closure Technique for Management of Forearm Compartment Syndrome Releases and Simple Upper-Extremity Wounds

Yoo, Jason J.; Fullerton, Natalia; Hui-Chou, Helen G.

doi:10.1016/j.jhsa.2021.01.008

Cited by 2 publications

(4 citation statements)

References 8 publications

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“…Indications for external tissue expansion include fasciotomy, multiple postsurgical wounds, donor site closure, and a variety of traumatic wounds. [16][17][18][19][20][21][22][23][24] Relative contraindications include poor skin quality, insufficient adjacent tissue, and infection.…”

Section: Discussionmentioning

confidence: 99%

“…The DermaClose device has demonstrated success in conjunction with negative pressure wound therapy. 16 Results were assessed at 2-to 36-week postoperative follow-up. Outcomes assessed include success of closure, need for secondary reconstruction, sensation in the area of reconstruction, incidence and severity of complications, and patient tolerance of treatment.…”

Section: Methodsmentioning

confidence: 99%

“…The DermaClose device has demonstrated success in conjunction with negative pressure wound therapy. 16…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

“The Treatment of Complex Extremity Wounds Using External Tissue Expansion: A Case Series”

Chan

Michel

Colon

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Summary: The goal of wound reconstruction is the approximation of soft tissue and re-establishment of an acceptable appearance with minimal risk of complications. For large wound closure in the extremities, skin graft and flap reconstruction are common treatments but are associated with a variety of complications. Comparatively, tissue expansion can provide the opportunity to reconstruct large wounds with native, durable, and sensate tissue without significant donor site morbidity. External tissue expansion is less invasive and avoids complications associated with internal expansion. The authors treated 11 patients with varying extremity wound types and sizes with an external tissue expansion device. Patient age ranged from 18 to 68 years with an average age of 43.7 years (SD, ±13.1 years). Average wound surface area was approximately 235 cm2 (SD, ±135.3 cm2). Devices were affixed and left for 7 to 11 days before closure of the wounds. Outcomes were assessed at 2 to 36 weeks postoperative follow-up. All wounds were fully closed after treatment without need for secondary reconstructive procedures. No patient experienced major complications. All patients demonstrated intact sensation within the area of reconstruction equivalent to surrounding tissues. External tissue expansion, an excellent treatment option in extremity reconstruction, is efficacious and associated with lower complication rates compared with internal tissue expansion, skin grafts, and flap reconstruction. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

“The Treatment of Complex Extremity Wounds Using External Tissue Expansion: A Case Series”

Chan

Michel

Colon

et al. 2022

Plastic &Amp; Reconstructive Surgery

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“…[18][19][20][29][30][31]33,34 The DermaClose device (Synovis) is an additional option that applies continuous external tissue expansion rather than relying on sequential tightening. 35 A systematic review comparing dynamic dermatotraction with gradual suture (shoelace) approximation and NPWT revealed delayed primary closure rates of 93%, 92%, and 78%, respectively. 36 Devices that cause direct compression of the wound margins should be used with caution.…”

Section: Mechanical Dermatotraction Devicesmentioning

confidence: 99%

Principles of Fasciotomy Closure After Compartment Syndrome Release

Sraj

Henderson

Bramer

et al. 2022

J Am Acad Orthop Surg

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Acute compartment syndrome is a surgical emergency in the extremities resulting from increased compartmental pressure, requiring immediate fasciotomy to resolve muscular compromise. As the mainstay treatment, fasciotomies involve substantial skin incisions and are thus prone to complications such as skin necrosis, wound infection, and permanent disability. Multidisciplinary care instituted at the time of fasciotomy can facilitate timely closure and minimize the complication profile. Several approaches are available to enhance outcomes of fasciotomy wounds, and a comprehensive knowledge of these options affords the treating surgeon greater flexibility and confidence in optimal management. Common techniques include early primary closure, gradual approximation, skin grafting, and negative pressure therapy. There is currently no consensus on the best method of closure. The purpose of this study was to review fasciotomy wound management from the time of initial release to final closure. Highlights include preparation for closing these wounds; the various techniques for fasciotomy closure, including adjunct options; evaluation of timing and staging; and injury-specific features, such as fracture management, limited subcutaneous tissues, and hand fasciotomies. Combining the perspectives of orthopaedic and plastic surgery, this review evaluates the benefits of multiple closure methods and highlights the importance of planning closure at the time of release.

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Continuous External Tissue Expansion Closure Technique for Management of Forearm Compartment Syndrome Releases and Simple Upper-Extremity Wounds

Cited by 2 publications

References 8 publications

“The Treatment of Complex Extremity Wounds Using External Tissue Expansion: A Case Series”

“The Treatment of Complex Extremity Wounds Using External Tissue Expansion: A Case Series”

Principles of Fasciotomy Closure After Compartment Syndrome Release

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