Comparison Of The Clinical Effect Of The New Skin Stretching Device And The Traditional Method For Wound Closure After Fasciotomy

Objective:Osteofascial compartment syndrome is an orthopedic emergency,the increased intracompartmental pressure causes acute limb ischemia;In milder cases conservative treatment can be choose,if the conservative treatment fails and patients are in a bad state of illness,fasciotomy should be performed.After fasciotomy the wound always cannot be closed directly,it needs the vacuum sealing drainage VSD cover,after waiting for edema relieve we need close it again.However due to the skin retraction and tissue edema,it cannot be closed directly.The traditional method is to take a skin graft or forcibly closed application of suture in the high tension.Skin graft is easy to cause scarring,forced closure of the wound causing skin necrosis because of high tension lead to skin loss of blood supply.This situation often needs the second operation processing.Traditional treatment has high complications and long treatment cycle and the high cost.So how to fast,efficient and with low tension after the closing of the minimally invasive bone fascia room open wound be the conundrum of clinicians.From 2015,our department use the new skin stretching device to close fascia chamber incision decompression wounds become a kind of new technology.In this paper,we use the new method compare with traditional closure of wound,provides a new method to close these wounds caused by fasciotomy.Methods:Retrospective statistical analysis the first hospital affiliated to dalian medical university in June 2013 to September 2016,38 cases of osteofascial compartment syndrome caused by trauma.All the patients with the fasciotomy for decompression,and according to the different way of closing the wound,we divided it into use skin stretching device group and traditional method group.Using skin stretching device group:there were 11 males and 3 females aged 11-60 years,with an average age of 37.2±15.1 years old,all of them had high tension incision before the incision was closed,three patients with preoperative endocrine diseases.Without using skin stretching device group:there were 19 males and 5 females,aged 10-69 years,with an average age of 36.5±14.4 years old,all of them had high tension incision before the incision was closed,cases of patients with preoperative endocrine diseases.Respectively on two groups of the general situation,we do comparison operation time,postoperative antibiotic use days,postoperative treatment times,hospitalization days after closure of the incision,healing of incision,ratings,etc.Results:Through the study of the statistical comparison of all patient data,analysis and comparison are made on two groups of patients' gender,age,parts and endocrine diseases,etc,there has no statistically significant difference(P>0.05);Days in the two groups in operative time,postoperative antibiotic use,postoperative treatment times,hospitalization days,hospitalization days after closure of the incision,healing of incision,grading and P values are less than 0.05,the difference has statistically significant.Using skin stretching device group and not use skin stretching device group compared with operation time,without using skin stretching device group takes less than using skin stretching machine group,P<0.05.The difference has statistically significant.Compare with antibiotic use days after operation,postoperative treatment times,comparison of the hospitalization days after incision closure,hospitalization days,using skin stretching device group less than traditional method group,P<0.05.The difference has statistically significant.In terms of incision healing score,the skin stretching device group is also better than without using skin stretching device group,P<0.05.The difference has statistically significant.Conclusion:Use of new stretching device makes the skin stretched,which the wounds can be closed in low tension.Avoid skin graft or skin flap surgery,compared with the traditional method,this technology has minimally invasive,simple operation.It provides a very safe and effective method for fascia chamber incision decompression wound.