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

1.	张敏, 李建香, 马文静, 等. 我国糖尿病流行病学和疾病经济负担研究现状. 世界最新医学信息文摘, 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.	鲁明, 张振, 宋明智, 等. 拉杆式皮肤扩展器Ⅰ期闭合筋膜间室切开减压术后创面. 中华创伤杂志, 2016, 32(3): 249-251.
6.	苑博, 王寿宇, 梁海东, 等. 新型拉杆式皮肤牵张器在修复 26 例患者四肢皮肤软组织缺损中的应用. 中华烧伤杂志, 2016, 32(12): 732-734.
7.	任高宏, 黎健伟, 黎润光, 等. 桥式皮瓣联合游离植皮负压封闭引流修复下肢大面积环形软组织缺损. 中华外科杂志, 2012, 50(1): 39-44.
8.	徐成, 鲁延林, 范锟铻. 负压封闭引流在糖尿病足治疗中的应用研究. 中国临床研究, 2016, 29(5): 627-628.
9.	朱新华, 柴益民, 叶吉忠, 等. 负压封闭引流和传统修复方法促进糖尿病足愈合的比较. 中国组织工程研究, 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.	董其强, 谷国俊, 王礼军, 等. 改良可调式皮肤牵张闭合器在皮肤及软组织缺损修复中的应用. 中国修复重建外科杂志, 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. 张敏, 李建香, 马文静, 等. 我国糖尿病流行病学和疾病经济负担研究现状. 世界最新医学信息文摘, 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. 鲁明, 张振, 宋明智, 等. 拉杆式皮肤扩展器Ⅰ期闭合筋膜间室切开减压术后创面. 中华创伤杂志, 2016, 32(3): 249-251.
6. 苑博, 王寿宇, 梁海东, 等. 新型拉杆式皮肤牵张器在修复 26 例患者四肢皮肤软组织缺损中的应用. 中华烧伤杂志, 2016, 32(12): 732-734.
7. 任高宏, 黎健伟, 黎润光, 等. 桥式皮瓣联合游离植皮负压封闭引流修复下肢大面积环形软组织缺损. 中华外科杂志, 2012, 50(1): 39-44.
8. 徐成, 鲁延林, 范锟铻. 负压封闭引流在糖尿病足治疗中的应用研究. 中国临床研究, 2016, 29(5): 627-628.
9. 朱新华, 柴益民, 叶吉忠, 等. 负压封闭引流和传统修复方法促进糖尿病足愈合的比较. 中国组织工程研究, 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. 董其强, 谷国俊, 王礼军, 等. 改良可调式皮肤牵张闭合器在皮肤及软组织缺损修复中的应用. 中国修复重建外科杂志, 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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