Upper Extremity Wound Closure Using External Tissue Expansion

Description

This video focuses on the technique of upper extremity wound closure using external tissue expansion, specifically the DermaClose system, devoid of any financial bias. It showcases the utilization of a self-tensioning continuous tissue expansion system designed to facilitate rapid and gentle closure of wounds, allowing for suturing and complete closure of full thickness skin defects. The applications for this technique span various fields, including plastic, orthopedic, and vascular surgery, particularly for scalp, trunk, and extremity wounds, while contraindications involve ischemic, non-viable infected tissue needing debridement prior to application.



The presentation features a case study involving a 30-year-old male with a fasciotomy defect on his upper arm due to compartment syndrome. The preparation process, including undermining skin flaps for optimal wound closure with minimal tissue expansion, is detailed alongside the placement of tensioning devices based on wound measurements. The suturing closures and protective measures to prevent maceration are carefully demonstrated, alongside successful lacing techniques for optimal device tensioning.



Additionally, further patient cases highlight post-operative outcomes revealing excellent healing progress, including successful prosthetic fitting post-amputation on patients with extensive soft tissue defects. The video concludes with an emphasis on the effectiveness of external tissue expansion as a viable solution for complex upper extremity defects.

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