Skin Traction Technique for Closure Large and Complex Skin Defects in Special Cases

Abstract

Objective: During the period of COVID-19 pandemic, the reconstructive surgeons don't want to take risks of complex and long operations, and to struggle with long recovery time after surgery as well as with associated donor-site morbidity. Therefore, they prefer much more simple techniques. The objective of this study is to evidence that skin traction technique is a simple, short term, useful, and good option for closing open wound complex defect which needs the reconstruction with large flap.Methods: Skin traction techniques were applied to ten patients who had large complex defects in our clinic between March 2020 and March 2021. Patient’s data including demographic characteristic, comorbidities, causes of defects, anatomic localization of defects, size of defect, time of closure defect, time interval of tightening suture, number of tightening sutures, time of staying in hospital, general complication was recorded.Results: The study included 8 males and 2 females. The average age of patients was 42.8 years ranging from 22 to 60. The size of defects ranged between 8x5 cm and 18x10 cm with an average of 11.7x7.2 cm. The average duration of follow-up was 6 months. After 3 months, we evaluated subjectively quality of skin thickness, mobility, and colour. Skin was thinner and less mobile in the areas that were reconstructed with graft when compared with skin traction territories where the colour of skin was also normal in the cases with skin defect which was repaired by primarily closure after skin traction. All patients were satisfied with results. Complications such as skin necrosis at the traction site and hematoma were not observed. Superficial wound infection was seen in one patient, and it was resolved with antibiotherapy.Conclusions: We suggest using the traction suture technique for complex defects as an easy, cheap, and short-time procedure to reconstruct large and complex skin defects especially in recipient vessel problems, cases suffered from flap failure, patients with comorbidities and special conditions (for example, during the COVID-19 pandemic).