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DOI: 10.4103/0970-0358.173137
A simple external tissue expansion technique based on viscoelastic properties of skin to attain direct closure of a large scalp defect: A case report
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Publication History
Publication Date:
26 August 2019 (online)
ABSTRACT
Background: Direct closure of large scalp defects is not an easy task. Complicated flap designs or staged surgeries over a period of 6 months are often required. A case of a large scalp defect that was closed directly in 3 months by applying a simple external tissue expansion technique is presented in this report. Patient Profile: A 28-year-old male patient presented with a painful swelling of about 13 cm × 14 cm, on frontoparietal scalp. A biopsy done elsewhere reported it to be a neurofibroma. He sought tumour excision and scalp defect coverage by hair-bearing scalp in a period of less than 5 months. Materials and Methods: The tumour was excised and the adjacent scalp was gradually expanded with the help of an external fixator. The patient had immediate pain relief after excision. The goal of repairing scalp defect and replacing it with hairy scalp was achieved in 3 months. Conclusion: The mechanical device required for this technique is relatively easily accessible. It is not difficult to achieve desirable outcomes, and the same can be applied to large wounds on other areas.
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KEY WORDS
Closure of large scalp defects - external tissue expansion - large scalp defects’ closure - scalp tissue expansion
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Conflicts of interest
There are no conflicts of interest.
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REFERENCES
- 1 Gibson T. Physical properties of skin. In: McCarthy JG. editor Plastic Surgery. Philadelphia: WB Saunders; 1990: p. 207-20
- 2 Levenson SM, Geever EF, Crowley LV, Oates 3 rd JF, Berard CW, Rosen H. The healing of rat skin wounds. Ann Surg 1965; 161: 293-308
- 3 Hirshowitz B, Baum E, Har-Shai Y. A skin-stretching device for the harnessing of the visco-elastic properties of skin. J Plast Reconstr Surg 1993; 92: 260-70
- 4 Mingli Z, Dawei W, Lan H. The application of skin external expander to postburn advanced scar contracture. Plast Reconstr Surg 1995; 96: 1600-7
- 5 Blomqvist G. ETE (external tissue expansion): A new method for external tissue extension. Ann Chir Plast Esthet 1996; 41: 577-81
- 6 Subramania KI, Mohit S, Sasidharan PR, Abraham MK, Arun P, Kekatpure V. ’Sure closure’-skin stretching system, our clinical experience. Indian J Plast Surg 2005; 38: 132-7
- 7 Lapid O. An improvised wound closure system. J Trauma 2006; 60: 910-4
- 8 Lasheen AE, Saad K, Raslan M. External tissue expansion in head and neck reconstruction. J Plast Reconstr Aesthet Surg 2009; 62: e251-4
- 9 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: 260-70
- 10 Kocialkowski A, Marsh DR, Shackley DC. Closure of the skin defect overlying infected non-union by skin traction. Br J Plast Surg 1998; 51: 307-10
- 11 Cohen BH, Cosmetto AJ. The suture tension adjustment reel: A new device for the management of skin closure. J Dermatol Surg Oncol 1992; 18: 112
- 12 Ger R, Evans JT, Oddsen R. A clinical trial of wound closure of constant tension approximation. Am J Surg 1996; 171: 331-4
- 13 Carmel NN, Silberman A, Li MS, Li YZ. The TopClosure® 3S System, for skin stretching and a secure wound closure. Eur J Plast Surg 2012; 35: 533-43
Address for correspondence:
-
REFERENCES
- 1 Gibson T. Physical properties of skin. In: McCarthy JG. editor Plastic Surgery. Philadelphia: WB Saunders; 1990: p. 207-20
- 2 Levenson SM, Geever EF, Crowley LV, Oates 3 rd JF, Berard CW, Rosen H. The healing of rat skin wounds. Ann Surg 1965; 161: 293-308
- 3 Hirshowitz B, Baum E, Har-Shai Y. A skin-stretching device for the harnessing of the visco-elastic properties of skin. J Plast Reconstr Surg 1993; 92: 260-70
- 4 Mingli Z, Dawei W, Lan H. The application of skin external expander to postburn advanced scar contracture. Plast Reconstr Surg 1995; 96: 1600-7
- 5 Blomqvist G. ETE (external tissue expansion): A new method for external tissue extension. Ann Chir Plast Esthet 1996; 41: 577-81
- 6 Subramania KI, Mohit S, Sasidharan PR, Abraham MK, Arun P, Kekatpure V. ’Sure closure’-skin stretching system, our clinical experience. Indian J Plast Surg 2005; 38: 132-7
- 7 Lapid O. An improvised wound closure system. J Trauma 2006; 60: 910-4
- 8 Lasheen AE, Saad K, Raslan M. External tissue expansion in head and neck reconstruction. J Plast Reconstr Aesthet Surg 2009; 62: e251-4
- 9 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: 260-70
- 10 Kocialkowski A, Marsh DR, Shackley DC. Closure of the skin defect overlying infected non-union by skin traction. Br J Plast Surg 1998; 51: 307-10
- 11 Cohen BH, Cosmetto AJ. The suture tension adjustment reel: A new device for the management of skin closure. J Dermatol Surg Oncol 1992; 18: 112
- 12 Ger R, Evans JT, Oddsen R. A clinical trial of wound closure of constant tension approximation. Am J Surg 1996; 171: 331-4
- 13 Carmel NN, Silberman A, Li MS, Li YZ. The TopClosure® 3S System, for skin stretching and a secure wound closure. Eur J Plast Surg 2012; 35: 533-43