Application of skin stretching device in repair of diabetic foot wound_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

GAO Lei , WANG Shuo , WANG Lei ,  WANG Jiangning

Department of Orthopaedic Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, P.R.China;

Corresponding?author：

WANG Jiangning, Email: dlwangjn@vip.sina.com

Keywords：

Diabetic foot; skin stretching device; vacuum sealing drainage; skin graft; wound healing

DOI：

10.7507/1002-1892.201801104

Video：

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ObjectiveTo evaluate the clinical value of skin stretching device in repair of diabetic foot wound.MethodsA retrospective analysis was made on the clinical data of 48 cases with diabetic foot wound who were treated with skin stretching device (trial group, n=24) and with the vacuum sealing drainage combined with skin graft (control group, n=24) respectively between October 2015 and July 2016. There was no significant difference in gender, age, side, course of disease, TEXAS stage between 2 groups (P>0.05). Both patients in 2 groups were treated with sensitive antibiotics according to the results of bacterial culture.ResultsOne case in control group was infected and the skin graft failed, and 1 case in trial group was infected after the treatment, and the two wounds healed after symptomatic treatment. The wounds of the other patients healed successfully, and the healing time of the trial group was significantly shorter than that of the control group [(12.8±11.6) days vs. (22.3±10.4) days; t=2.987, P=0.005). All patients were followed up 3-12 months after operation, and no wound dehiscence or recurrence occurred during follow-up.ConclusionCompared with the vacuum sealing drainage combined with skin graft, the application of skin stretching device in the repair of diabetic foot wound has advantages, such as easy to operate, shorten the wound healing time, and the appearance of wound was similar with the adjacent skin.

Citation： GAO Lei, WANG Shuo, WANG Lei, WANG Jiangning. Application of skin stretching device in repair of diabetic foot wound. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(5): 591-595. doi: 10.7507/1002-1892.201801104 Copy

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2.	Sanz-Corbalán I, Lázaro-Martínez JL, García-Morales E, et al. Advantages of early diagnosis of diabetic neuropathy in the prevention of diabetic foot ulcers. Diabetes Res Clin Pract, 2017. [Epub ahead of print].
3.	Sekhar MS, Mk U, Vyas N, et al. Development and evaluation of patient information leaflet for diabetic foot ulcer patients. Int J Endocrinol Metab, 2017, 15(3): e55454.
4.	Armstrong DG. The University of Texas Diabetic Foot Classification System. Ostomy Wound Manage, 1996, 42(8): 60-61.
5.	魯明, 張振, 宋明智, 等. 拉桿式皮膚擴展器Ⅰ期閉合筋膜間室切開減壓術后創面. 中華創傷雜志, 2016, 32(3): 249-251.
6.	苑博, 王壽宇, 梁海東, 等. 新型拉桿式皮膚牽張器在修復 26 例患者四肢皮膚軟組織缺損中的應用. 中華燒傷雜志, 2016, 32(12): 732-734.
7.	任高宏, 黎健偉, 黎潤光, 等. 橋式皮瓣聯合游離植皮負壓封閉引流修復下肢大面積環形軟組織缺損. 中華外科雜志, 2012, 50(1): 39-44.
8.	徐成, 魯延林, 范錕铻. 負壓封閉引流在糖尿病足治療中的應用研究. 中國臨床研究, 2016, 29(5): 627-628.
9.	朱新華, 柴益民, 葉吉忠, 等. 負壓封閉引流和傳統修復方法促進糖尿病足愈合的比較. 中國組織工程研究, 2014, 18(34): 5548-5554.
10.	Takei T, Danjo S, Sakoguchi S, et al. Autoclavable physically-crosslinked chitosan cryogel as a wound dressing. Biosci Bioeng, 2017. [Epub ahead of print].
11.	Hodgson H, Davidson D, Duncan A, et al. Clinical evaluation of a hydro-responsive wound dressing: the Glasgow experience. J Wound Care, 2017, 26(11): 642-650.
12.	De Marchi JGB, Jornada DS, Silva FK. Triclosan resistance reversion by encapsulation in chitosan-coated-nanocapsule containing α-bisabolol as core: development of wound dressing. Int J Nanomedicine, 2017, 12: 7855-7868.
13.	von Cramon L, Markowicz M, Nebendahl J, et al. A clinical evaluation of a transparent, absorbent, adhesive wound dressing. Br J Nurs, 2017, 26(Sup20): S46-S53.
14.	Hirshowitz B, Lindenbaum E, Har-Shai Y. A skin-stretching device for the harnessing of the viscoelastic properties of skin. Plast Reconstr Surg, 1993, 92(2): 260-270.
15.	Melis P, Noorlander ML, van der Horst CM, et al. Rapid alignment of collagen fibers in the dermis of undermined and not undermined skin stretched with a skin-stretching device. Plast Reconstr Surg, 2002, 109(2): 674-680.
16.	Pavletic MM. Use of an external skin-stretching device for wound closure in dogs and cats. J Am Vet Med Assoc, 2000, 217(3): 350-354.
17.	Melis P, Bos KE, Horenblas S. Primary skin closure of a large groin defect after inguinal lymphadenectomy for penile cancer using a skin stretching device. J Urol, 1998, 159(1): 185-187.
18.	Song M, Zhang Z, Liu T. EASApprox^? skin-stretching system: A secure and effective method to achieve wound closure. Exp Ther Med, 2017, 14(1): 531-538.
19.	董其強, 谷國俊, 王禮軍, 等. 改良可調式皮膚牽張閉合器在皮膚及軟組織缺損修復中的應用. 中國修復重建外科雜志, 2017, 31(12): 1481-1484.
20.	Cheng LF, Lee JT, Hsu H, et al. Simple skin-stretching device in assisted tension-free wound closure. Ann Plast Surg, 2017, 78(3 Suppl 2): S52-S57.

1. 張敏, 李建香, 馬文靜, 等. 我國糖尿病流行病學和疾病經濟負擔研究現狀. 世界最新醫學信息文摘, 2017, 17(56): 176.
2. Sanz-Corbalán I, Lázaro-Martínez JL, García-Morales E, et al. Advantages of early diagnosis of diabetic neuropathy in the prevention of diabetic foot ulcers. Diabetes Res Clin Pract, 2017. [Epub ahead of print].
3. Sekhar MS, Mk U, Vyas N, et al. Development and evaluation of patient information leaflet for diabetic foot ulcer patients. Int J Endocrinol Metab, 2017, 15(3): e55454.
4. Armstrong DG. The University of Texas Diabetic Foot Classification System. Ostomy Wound Manage, 1996, 42(8): 60-61.
5. 魯明, 張振, 宋明智, 等. 拉桿式皮膚擴展器Ⅰ期閉合筋膜間室切開減壓術后創面. 中華創傷雜志, 2016, 32(3): 249-251.
6. 苑博, 王壽宇, 梁海東, 等. 新型拉桿式皮膚牽張器在修復 26 例患者四肢皮膚軟組織缺損中的應用. 中華燒傷雜志, 2016, 32(12): 732-734.
7. 任高宏, 黎健偉, 黎潤光, 等. 橋式皮瓣聯合游離植皮負壓封閉引流修復下肢大面積環形軟組織缺損. 中華外科雜志, 2012, 50(1): 39-44.
8. 徐成, 魯延林, 范錕铻. 負壓封閉引流在糖尿病足治療中的應用研究. 中國臨床研究, 2016, 29(5): 627-628.
9. 朱新華, 柴益民, 葉吉忠, 等. 負壓封閉引流和傳統修復方法促進糖尿病足愈合的比較. 中國組織工程研究, 2014, 18(34): 5548-5554.
10. Takei T, Danjo S, Sakoguchi S, et al. Autoclavable physically-crosslinked chitosan cryogel as a wound dressing. Biosci Bioeng, 2017. [Epub ahead of print].
11. Hodgson H, Davidson D, Duncan A, et al. Clinical evaluation of a hydro-responsive wound dressing: the Glasgow experience. J Wound Care, 2017, 26(11): 642-650.
12. De Marchi JGB, Jornada DS, Silva FK. Triclosan resistance reversion by encapsulation in chitosan-coated-nanocapsule containing α-bisabolol as core: development of wound dressing. Int J Nanomedicine, 2017, 12: 7855-7868.
13. von Cramon L, Markowicz M, Nebendahl J, et al. A clinical evaluation of a transparent, absorbent, adhesive wound dressing. Br J Nurs, 2017, 26(Sup20): S46-S53.
14. Hirshowitz B, Lindenbaum E, Har-Shai Y. A skin-stretching device for the harnessing of the viscoelastic properties of skin. Plast Reconstr Surg, 1993, 92(2): 260-270.
15. Melis P, Noorlander ML, van der Horst CM, et al. Rapid alignment of collagen fibers in the dermis of undermined and not undermined skin stretched with a skin-stretching device. Plast Reconstr Surg, 2002, 109(2): 674-680.
16. Pavletic MM. Use of an external skin-stretching device for wound closure in dogs and cats. J Am Vet Med Assoc, 2000, 217(3): 350-354.
17. Melis P, Bos KE, Horenblas S. Primary skin closure of a large groin defect after inguinal lymphadenectomy for penile cancer using a skin stretching device. J Urol, 1998, 159(1): 185-187.
18. Song M, Zhang Z, Liu T. EASApprox^? skin-stretching system: A secure and effective method to achieve wound closure. Exp Ther Med, 2017, 14(1): 531-538.
19. 董其強, 谷國俊, 王禮軍, 等. 改良可調式皮膚牽張閉合器在皮膚及軟組織缺損修復中的應用. 中國修復重建外科雜志, 2017, 31(12): 1481-1484.
20. Cheng LF, Lee JT, Hsu H, et al. Simple skin-stretching device in assisted tension-free wound closure. Ann Plast Surg, 2017, 78(3 Suppl 2): S52-S57.

Chinese Journal of Reparative and Reconstructive Surgery

Application of skin stretching device in repair of diabetic foot wound

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