A Skin-stretching Wound Closure System to Prevent and Manage Dehiscence of High-tension Flap Donor Sites: A Report of 2 Cases.
Tension on the suture line of flap donor sites raises the risk of delayed healing and wound dehiscence. Closing a large flap donor site without a skin/flap graft is a major surgical challenge. Recently, the authors started using a skin-stretching wound closure system designed to harness both mechanical creep and stress-relaxation principles for the management of a variety of surgically closed wounds, including flap donor sites. The system consists of a pair of attachment plates connected by a long, flexible approximation strap that can be invasively (sutured) or noninvasively (by adhesion) secured to the skin wound edges and gradually tightened. The care and outcomes of 2 of the 41 patients whose wounds were managed with this system at the authors\'92 plastic/reconstructive and wound repair center during a period of 7 months are described. The first case involved a 20-year-old patient with a 16 cm x 8 cm deep inferior epigastric perforator flap to reconstruct a malignant tumor resection of the groin. The second patient required a 10 cm x 8 cm anterolateral thigh free-flap to repair a traumatic dorsal skin, soft tissue defect. Wounds were assessed and tension adjusted every 2 or 3 days. Both lesions healed by primary intention and with a good cosmetic outcome. Controlled clinical studies are needed to examine the effectiveness, efficacy, indications, complications, and cost effectiveness of this closure system.
Department of Plastic Surgery, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hang Zhou, P.R. China.
Xue
X
Dan
Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Jiang
J
Hongfei
Department of Plastic Surgery, Second Affiliated Hospital, College of Medicine, Zhejiang University.
Zhang
Z
Huahui
Department of Burns and Wound Center, Second Affiliated Hospital, College of Medicine, Zhejiang University.
Han
H
Chunmao
Department of Burns and Wound Center, Second Affiliated Hospital, College of Medicine, Zhejiang University.
Hu
H
Hang
D034861:Abdominal Wall / Q000601:surgery; D058107:Abdominal Wound Closure Techniques / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods; D016038:Skin Transplantation / Q000009:adverse effects* / Q000534:rehabilitation; D013524:Surgical Flaps / Q000009:adverse effects; D013529:Surgical Wound Dehiscence / Q000451:nursing* / Q000503:physiopathology; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult