Role of Preoperative Skin Stretching in Single-Stage Wound Closure

Anchit Kumar; Naveen Kumar; Manoj K Jha

doi:10.1055/s-0042-1756131

Role of Preoperative Skin Stretching in Single-Stage Wound Closure

Indian J Plast Surg. 2022 Oct 31;55(3):287-293. doi: 10.1055/s-0042-1756131. eCollection 2022 Jun.

Authors

Anchit Kumar¹, Naveen Kumar², Manoj K Jha³

Affiliations

¹ Centre for Plastic Cosmetic Surgery, BLK Superspeciality Hospital, New Delhi, India.
² Department of Plastic Surgery, Lady Hardinge Medical College and Associated Hospital, New Delhi, India.
³ Department of Burns, Plastic and Reconstructive Surgery, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India.

Abstract

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 cm ² , 9 (30%) were between 50 and 75 cm ² , and 5 (16.7%) were >75 cm ² . 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.

Keywords: Device; Skin; Stretching; Tension; Wound.

Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).