Abstract
Skin and soft tissue loss is very common in modern high velocity trauma. Such wounds pose problem of coverage. We present a good alternative to skin grafting & flaps i.e. SINGH’S skin traction device for wound closure in these patients.
The technique is based on the principle of tissue expansion and makes use of viscoelastic properties of the skin i.e. creep and stress relaxation. 100 cases with 116 wounds with skin and soft tissue loss were treated. Two parallel kirshner wires (1.5mm) were passed through the dermis on either side of the wound margins and interconnected by compression device consisting of threaded rod having two blocks and compression knob. Gradual compression approximated the wound margins. Patients ranged in age from 15 to 65 years with average age of 30.5 years. Main modes of injury were roadside accidents and machinery accidents. Average operating time was about 20 minutes. 50 amputation stump wounds were also treated.
Excellent results were observed in 48 (41.4%), good in 42 (36.2%), fair in 14 (12%) and poor in 12 (10.4%) wounds. Main complication was cutting through of wires.
We found that this technique is simple, economical and effective. No special training and instruments are needed and can be done by junior surgeon at small centres. It provides full thickness cover to the wound which matches the surrounding normal skin in quality, sensations and colour. Above all this technique can be successfully used in infected wounds and wounds with exposed bone and tendons. Careful gradual compression judged by pain and blanching gives better results and fewer complications.
The abstracts were prepared by Mr Tim Briggs. (Editoral Secretary 2003/4) Correspondence should be addressed to him at Lane Farm, Chapel Lane, Totternhoe, Dunstable, Bedfordshire LU6 2BZ, United Kingdom
