title: Adhesive skin closure technique for closure of fasciotomy wounds in pediatric patients: a case series.
abstract: BACKGROUND
  Closure of fasciotomy wounds poses a challenge, particularly in pediatric cardiac patients who are too high risk for general anesthesia and often require anticoagulant treatment. The adhesive skin closure technique enables wound closure without the need for a secondary procedure such as surgery requiring anesthesia.
  
  
  OBJECTIVE
  This study sought to describe a treatment modality that assists in fasciotomy wound edge approximation without the need for surgery, while additionally aiding in achieving fast and aesthetic results in the aforementioned patient population. A case series of 4 pediatric patients with fasciotomy wounds is presented.
  
  
  METHODS
  Adhesive skin closure strips (Steri-Strips, 3M, St. Paul, MN) were placed perpendicular to the cleansed wound leaving small gaps for drainage, thus achieving complete propinquity. The strips were replaced sequentially with new strips every 2 to 3 days. Digital pictures of the wounds were obtained until complete closure of the wounds was achieved. Outcome variables included wound closure success rates and complication rates including infection, bleeding, and late scar formation.
  
  
  RESULTS
  Patient ages ranged from 2 weeks to 2 years, 9 months (mean: 10.5 months), average period of open wound prior to closure was 6.75 days (range: 5-11 days), treatment duration ranged from 15 to 26 days (mean: 21 days), and average follow-up was 4.5 months. One patient died due to their primary condition. No local infections, wound dehiscence with the treatment regimen, or any other immediate complications were encountered. There was a late complication in 1 patient who presented with a hypertrophic scar.
  
  
  CONCLUSIONS
  Use of the adhesive skin closure method to close fasciotomy wounds in pediatric patients in which surgical procedures were nonadvisable produced favorable results.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Tel HaShomer, Israel; and The 2015 Dr. Pinchas Borenstein Talpiot Medical Leadership Program, The Chaim Sheba Medical Center, Tel HaShomer, Israel;
authors.forename: Oren
authors.initials: O
authors.lastname: Weissman
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Tel HaShomer, Israel;
authors.forename: Noga
authors.initials: N
authors.lastname: Goldman
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Tel HaShomer, Israel.
authors.forename: Demetris
authors.initials: D
authors.lastname: Stavrou
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Tel HaShomer, Israel.
authors.forename: Liran
authors.initials: L
authors.lastname: Barzilai
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Tel HaShomer, Israel.
authors.forename: Gil
authors.initials: G
authors.lastname: Grabov Nardini
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Tel HaShomer, Israel.
authors.forename: Nimrod
authors.initials: N
authors.lastname: Farber
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Tel HaShomer, Israel.
authors.forename: Isaac
authors.initials: I
authors.lastname: Zilinsky
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Tel HaShomer, Israel.
authors.forename: Eyal
authors.initials: E
authors.lastname: Winkler
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Tel HaShomer, Israel; and The Talpiot Medical Leadership Program, The Chaim Sheba Medical Center, Tel HaShomer, Israel.
authors.forename: Josef
authors.initials: J
authors.lastname: Haik
mesh_terms: D002675:Child, Preschool; D003161:Compartment Syndromes / Q000601:surgery*; D005205:Fascia / Q000473:pathology; D000071938:Fasciotomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D017410:Practice Guidelines as Topic; D013529:Surgical Wound Dehiscence / Q000517:prevention & control*; D014014:Tissue Adhesives; D016896:Treatment Outcome; D058106:Wound Closure Techniques / Q000295:instrumentation; D014945:Wound Healing
chemical_list: D014014:Tissue Adhesives