Long-Term Results of Wounds Closed under a Significant Amount of Tension

Abstract

This study demonstrates the considerable difference in scar formation among scalp, back, and shoulder defects compared with those on the extremities, groin, and thigh.

Efficacy of Skin Stretching for Burn Scar Excision: A Multicenter Randomized Controlled Trial

“…Except for the prospective research of Daya and Nair on traction-assisted dermatogenesis for large scar excisions, which works by biological creep, no other techniques are available that showed a benefit for reducing a multistep procedure to a one-step procedure. 33 In a previously published article by Melis et al, the wounds closed with a skin-stretching device measured 5.6 ϫ 9.6 cm (n ϭ 28), 22 whereas the wounds in our skin stretch study group measured 8.8 ϫ 23.5 cm. Although the mean size of our wounds was considerably larger, one should note that different selection criteria were applied.…”

“…22 In this study, the mean width of the wound was 56.4 Ϯ 19.2 mm and the mean reduction of the surface area was 72.9 Ϯ 25.5 percent. The clinical intended effect for this randomized controlled trial was a scar reduction of at least 50 percent.…”

“…20 In a clinical study, they demonstrated in 30 patients that, even though the wounds were closed under a significant amount of tension, a relatively thin scar was achieved, as was a low incidence of hypertrophic scarring (7.1 percent). 22 However, so far, no randomized controlled trial has been published, which proves that primary closure with intraoperative skin stretching allows closure of significantly larger wounds than primary closure of a wound without additional techniques. For this reason, we initiated this randomized controlled trial in which we evaluated the efficacy of the skinstretching device for burn scar excision.…”

“…The skin-stretching device has been described as a useful tool for the primary closure of wounds. [17][18][19][20][21][22][23][24] Melis et al showed that large defects can be closed by using this device. 20 In a clinical study, they demonstrated in 30 patients that, even though the wounds were closed under a significant amount of tension, a relatively thin scar was achieved, as was a low incidence of hypertrophic scarring (7.1 percent).…”

On the surgical treatment of hypertrophic scars: a comprehensive guideline for the surgical treatment of hypertrophic scars

“…By applying intermittent and controlled load of 30 Newton on the wound edges, tissue can be gained without compromising blood supply and the quality of the skin. In a clinical study Melis et al demonstrated that, even though wounds were closed under a significant amount of tension, a relatively narrow scar was achieved and a low incidence of hypertrophic scarring (7.1%) [28]. In a randomised controlled trial Verhaegen et al studied the effectiveness of wound closure with a skin stretching device [27].…”