Soft Tissue Injury Management With a Continuous External Tissue Expander

Santiago, Gabriel; Bograd, Benjamin; Basile, Patrick; Howard, Robert T.; Fleming, Mark E.; Valerio, Ian L.

doi:10.1097/sap.0b013e31824a4584

Cited by 43 publications

(35 citation statements)

References 14 publications

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“…The common disadvantages of the skin-stretching method included the following: (1) surrounding wounds and scars from the extra staples or additional suture areas, (2) pain from staple anchorage when there is excessive tension on the elastic rubber bands, and (3) undue elastic pressure can injure normal skin flaps. The method cannot be applied to either scarred areas or skin flaps with insufficient undermining; reconstructing such large defects can be performed by employing other optimal skin-stretching devices 18,19 or by using skin grafts, regional flaps, or even free flaps.…”

Section: Discussionmentioning

confidence: 99%

Simple Skin-Stretching Device in Assisted Tension-Free Wound Closure

Cheng

Lee

Hsu

et al. 2017

Annals of Plastic Surgery

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Background Numerous conventional wound reconstruction methods such as wound undermining with direct suture, skin graft, and flap surgery can be used to treat large wounds. The adequate undermining of the skin flaps of a wound is a commonly used technique for achieving the closure of large tension wounds; however, the use of tension to approximate and suture the skin flaps can cause ischemic marginal necrosis. The purpose of this study is to use elastic rubber bands to relieve the tension of direct wound closure for simultaneously minimizing the risks of wound dehiscence and wound edge ischemia that lead to necrosis. Materials and Methods This retrospective study was conducted to evaluate our clinical experiences with 22 large wounds, which involved performing primary closures under a considerable amount of tension by using elastic rubber bands in a skin-stretching technique following a wide undermining procedure. Assessment of the results entailed complete wound healing and related complications. Results All 22 wounds in our study showed fair to good results except for one. The mean success rate was approximately 95.45%. Conclusion The simple skin-stretching design enabled tension-free skin closure, which pulled the bilateral undermining skin flaps as bilateral fasciocutaneous advancement flaps. The skin-stretching technique was generally successful.

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Section: Discussionmentioning

confidence: 99%

Simple Skin-Stretching Device in Assisted Tension-Free Wound Closure

Cheng

Lee

Hsu

et al. 2017

Annals of Plastic Surgery

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“…9). 24 Our group has successfully used external tissue expansion (eg, Dermaclose) to facilitate FIGURE 5. A, Right transtibial amputation revealing significant soft tissue loss with preservation of the extensor mechanism.…”

Section: Reconstructive Laddermentioning

confidence: 99%

Application of the Orthoplastic Reconstructive Ladder to Preserve Lower Extremity Amputation Length

Fleming

O’Daniel

Bharmal

et al. 2014

Annals of Plastic Surgery

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The preservation of residual limb length in lower extremity amputations is crucial to optimize prosthetic fitting and to obtain the maximal functional outcome. A series of cases are presented that outline soft tissue coverage options for preserving maximal residual limb length. Applying various concepts from the reconstructive ladder may allow for viable soft tissue coverage to maximize functional outcome.

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“…Since the first utilization in 1957 (Neumann, 1957), the use of tissue expansions have become widespread in maxillary and craniofacial surgery (Kobus, 2007), burn scar excision (Hafezi et al, 2009), breast reconstruction following mastectomy (Lohsiriwat et al, 2013), ophthalmology (Hou et al, 2012), management of omphalocele (Clifton et al, 2011), nasal reconstruction (Kheradmand et al, 2011), scalp alopecia (Guzey et al, 2015) and other deformities in plastic reconstructive surgery (Motamed et al, 2008; Laurence et al, 2012; Santiago et al, 2012). Tissue expander generates new tissues, by exploiting the viscoelastic properties of the skin and adjusted histological changes which follows the principle of the controlled mechanical skin overstretch (Argenta, 1984; Pamplona et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Cellular and Molecular Responses to Mechanical Expansion of Tissue

et al. 2016

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The increased use of tissue expander in the past decades and its potential market values in near future give enough reasons to sum up the consequences of tissue expansion. Furthermore, the patients have the right to know underlying mechanisms of adaptation of inserted biomimetic, its bioinspired materials and probable complications. The mechanical strains during tissue expansion are related to several biological phenomena. Tissue remodeling during the expansion is highly regulated and depends on the signal transduction. Any alteration may lead to tumor formation, necrosis and/or apoptosis. In this review, stretch induced cell proliferation, apoptosis, the roles of growth factors, stretch induced ion channels, and roles of second messengers are organized. It is expected that readers from any background can understand and make a decision about tissue expansion.

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Soft Tissue Injury Management With a Continuous External Tissue Expander

Cited by 43 publications

References 14 publications

Simple Skin-Stretching Device in Assisted Tension-Free Wound Closure

Simple Skin-Stretching Device in Assisted Tension-Free Wound Closure

Application of the Orthoplastic Reconstructive Ladder to Preserve Lower Extremity Amputation Length

Cellular and Molecular Responses to Mechanical Expansion of Tissue

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