Evaluation of a new tension relief system for securing wound closure: a single-centre, Chinese cohort study

Zhang, Huahui; Dan, Xue; Jiang, Hongfei; Hu, Hang; Han, Chunmao; Ren, Haitao; Jiang, Yu; Zhang, Tao

doi:10.1177/229255031602400306

Cited by 9 publications

(14 citation statements)

References 8 publications

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“…Currently, many surgical methods such as skin graft, local flap, free tissue transfer procedure, tissue expansion, or various combinations of the aforementioned options have been used to close these large defects following tumor resection [6-8, 10-13, 22-26]. Of these methods, tissue expansion procedure may be a promising, cost-effective treatment option [22,[24][25][26]. It significantly downgrades surgical complexity, reduces operating time, and shortens hospital stay.…”

Section: Discussionmentioning

confidence: 99%

“…In 1993, Hirschowitz et al firstly described an external skin-stretching device which harnesses the viscoelastic properties of the skin to close open wounds [ 13 ]. Since then, many modifications, such as SureClosure®, Wiseband®, and TopClosure®, have been introduced and reported by different authors and obtained acceptable outcomes [ 7 – 10 , 12 , 15 , 25 , 29 ] (Table 2 ). However, due to geographical, economical, or other special factors, many of them are not used in many hospitals or countries.…”

Section: Discussionmentioning

confidence: 99%

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A novel skin-stretching device for closing large skin-soft tissue defects after soft tissue sarcoma resection

Shao

et al. 2020

World J Surg Onc

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Background Closure of large skin-soft tissue defects following soft tissue sarcoma (STS) resection has been a great challenge. The objective of this study was to evaluate the effectiveness of a novel, simple, and cheap skin-stretching device (bidirectional regulation-hook skin closure system, BHS) for closing large skin-soft tissue defects resulting from the removal of STS and the complications associated with the use of the BHS. Methods From January 2017 to September 2018, 25 patients with STS underwent BHS therapy after tumor resection. BHS was used for two main clinical applications: securing wound closure after high-tension suture closure and delayed wound closure. We described a detailed reconstruction procedure regarding this therapy. Wound closure and complications associated with BHS therapy were recorded. We also analyzed tumor recurrence and metastases. Results All patients were observed for 16–36 months with an average follow-up of 25.6 months. During the follow-up period, no significant functional restriction was observed and the final scar was aesthetically acceptable. Superficial wound infection occurred in six patients, wound edge ischemia in two patients, and small skin tears in two patients. Two patients developed pulmonary metastasis, two patients had a local recurrence, and one patient died of pulmonary metastasis. Conclusions BHS therapy can effectively close large skin-soft tissue defects following STS resection and obtain acceptable functional results, without severe complications. However, larger studies are required to further evaluate the effectiveness, indications, and complications of BHS therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A novel skin-stretching device for closing large skin-soft tissue defects after soft tissue sarcoma resection

Shao

et al. 2020

World J Surg Onc

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“…It should be noted that, in cases of breakage of the wires, it would not be possible to reapply the wires at the bedside without anaesthesia. Other than these personal techniques, a number of wound closure devices have been designed in the recent past, such as Sure-Closure (Life Medical Sciences, Princeton, New Jersey), 11 Wisebands (Wisebands Company, Misgav, Israel), 14 and TopClosure (IVT Medical, Ra'anana, Israel) 15,16 that cannot be used widespread in clinical practice due to high cost and low availability.…”

Section: Discussionmentioning

confidence: 99%

“…In a recent clinical study performed by Huahui et al, 16 41 patients with a total of 43 wounds were treated by the TopClosure system. The mean duration of the treatment cycle was reported as 16.72 days, which was significantly higher than the average of 4.8 days in our patients.…”

Section: Discussionmentioning

confidence: 99%

“…The technique mainly takes advantages of viscoelastic properties of the skin, including mechanical creep and stress relaxation, which promote stretching capacity of the skin beyond its normal state, when a constant force is applied. 1,2 Various techniques using Kirschner wires, 1,3-6 suture anchors, 2,7 Steri-Strips, 8 plastic straps, 9 silastic vessel loops, 10 and specially designed devices [11][12][13][14][15][16] were described for this purpose.…”

Section: Introductionmentioning

confidence: 99%

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Delayed Primary Closure of Traumatic Tension Wounds Using Plastic Straps and Kirschner Wires

et al. 2018

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Tension of the wound edges should be overcome with precise surgical planning, which is recognized as one of the major contributors to local complications by compromising circulation of the wound edges. In this article, it was aimed to present the clinical results of a surgical technique, in which the plastic straps and Kirschner wires are used for delayed primary closure of traumatic tension wounds. Depending on the assessment of the wound localization, wound dimension, and mobility of adjacent soft tissue, the technique was performed in 9 patients with a male to female ratio of 8:1. Gunshot injury was the leading cause (n ¼ 5), and in most cases, the wounds were located at the lower extremities (n ¼ 6). The mean time between performing the technique and closing the wound primarily and the mean hospitalization time were 4.8 + 1.1 and 13.5 + 3.9 days, respectively. In each case, wound closure and healing were achieved successfully without any serious complications. The presented technique provides advantages of using a low cost as well as a very simple equipment, improved and reliable stability during tightening process due to self-locking feature of the plastic straps, no donor site morbidity, short operating time with low rate of post-operative complications, and short hospitalization time. We recommend using this invaluable technique reliably for the treatment of traumatic tension wounds. However, further studies are needed for better evaluation of cosmetic and functional outcomes of the presented technique. Résumé Il faut une planification chirurgicale précise pouréviter la tension au pourtour des plaies, qui est reconnue comme l'un des principauxéléments responsables des complications locales. En effet, la tension compromet la circulation au pourtour des plaies. Dans le présent article, les auteurs ont cherché à présenter les résultats cliniques d'une technique chirurgicale qui fait appel à des bandes de plastique et à des broches de Kirschner pour retarder la fermeture primaire des plaies de tension traumatiques.

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Role of Preoperative Skin Stretching in Single-Stage Wound Closure

Kumar

Jha

2022

Indian J Plast Surg

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Background Mechanical skin stretching (SS) is now becoming one of the commonly sought after procedures for wound healing. This study was aimed to assess the efficacy of preoperative SS for the closure of large wounds and to evaluate various postoperative outcome parameters. Methodology An observational study was conducted from December 2017 to May 2019 where a sample size of 30 patients was included with inclusion criteria being wounds of ≥5 cm width that require surgical management, presence of sufficient healthy skin edge of the wound/scar (at least one) for the stretching procedure, and age between 18 and 70 years. SS devices used were the top closure tension relief system. Postoperatively, various parameters were recorded to evaluate outcomes and complications. Results Majority of wounds that is 16 (53.3%) were <50 cm2, 9 (30%) were between 50 and 75 cm2, and 5 (16.7%) were >75 cm2. The mean duration of stretch was 2.3 ± 0.82 weeks. For 30 wounds treated with staged cycles of wound closure, there was a significant difference between every two visit points, i.e., 10%. The mean patient-reported patient and observer scar assessment scale score was 3.5 ± 0.93. Twenty-five cases (83.3%) had uneventful postoperative recovery. Twenty-seven patients (90%) reported an improved aesthetic outcome. Fourteen patients (46.7%) reported some improvement in function. Conclusion The study concluded that the SS devices are the simple and effective method for the primary closure of large and challenging wounds and skin defects.

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Evaluation of a new tension relief system for securing wound closure: a single-centre, Chinese cohort study

Cited by 9 publications

References 8 publications

A novel skin-stretching device for closing large skin-soft tissue defects after soft tissue sarcoma resection

A novel skin-stretching device for closing large skin-soft tissue defects after soft tissue sarcoma resection

Delayed Primary Closure of Traumatic Tension Wounds Using Plastic Straps and Kirschner Wires

Role of Preoperative Skin Stretching in Single-Stage Wound Closure

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