Dynamic Closing Method Using Elasticity for Skin Defect

Han, Dae Yong; Hahn, Soo Bong; Yang, Kyu Hyun; Kim, Hyong Jeong

Abstract

Skin defects unable to close by primary intention have caused many difficulties. Complex surgical interventions such as repetitive debridements, skin graft, or flap have been performed as therapeutic methods. Recently, new techniques for the skin closure based on the stretching property, elasticity or stress relaxation, have been introduced. This biomechanical property exhibits that the force required to keep the skin at a stretched length decreases over time. As the skin is stretching, the convoluted collagen fibers in dermis are straighten and become a line in the direction of stretching force. Fifteen cases of skin defects associated with fracture were closed by a new dynamic closing method at Department of Orthopaedic Surgery, Yonsei University College of Medicine. Two spinal needles were inserted into dermis along the wound margins on each side in order to distribute the even tension. The wound margins were approximated by suture wires engaged with the needles. We have experienced successful results using new stretch closing method in fracture with skin defect. It is confirmed that this method is rapid, simple, cost-effective, cosmetic, and safe way to close the skin defect and shortens hospital stay.