Karkos Christos D, Papoutsis Ioakeim, Giagtzidis Ioakeim T, Pliatsios Ioannis, Mitka Maria-Aphroditi, Papazoglou Konstantinos O, Kambaroudis Apostolos G
1 Aristotle University of Thessaloniki, Thessaloniki, Greece.
Int J Low Extrem Wounds. 2018 Jun;17(2):113-119. doi: 10.1177/1534734618765343. Epub 2018 Mar 26.
Management of large postfasciotomy wounds and/or skin and soft tissue defects after major vascular trauma to the extremities can be challenging. The External Tissue Extender (Blomqvist; ETE), a skin-stretching device, which consists of silicone tapes and plastic stoppers, approximates wound margins and facilitates delayed primary closure. We describe our experience with the use of ETE in 5 patients (4 males) with a total of 8 wounds (7 postfasciotomy, 1 soft tissue defect) over the past 12 years. The mean patient age was 32 (range 17-61) years. The wounds involved the lower limb in 3 patients and the upper limb in 2, whereas the injured arteries were the popliteal in 3, the axillary in 1, and the brachial in 1. The mean wound length was 24 cm (range 9-37 cm), and the mean number of ETE silicone tapes used per wound was 13 (range 5-19). The median duration of ETE therapy was 7 days (range 4-7). ETE therapy resulted in sufficient wound approximation to allow complete closure with conventional suturing in 7 out of the 8 wounds. Of these, one developed infection that required drainage, debridement, and resuturing. All wounds achieved satisfactory healing status and all limbs had been salvaged. In conclusion, the ETE is a useful, easy-to-use, and simple adjunct that may facilitate delayed primary closure of large postfasciotomy wounds or extensive skin and soft tissue defects following complex vascular trauma to the extremities.
对四肢严重血管创伤后出现的大面积筋膜切开术后伤口和/或皮肤及软组织缺损进行处理可能具有挑战性。外部组织扩张器（布洛姆奎斯特；ETE）是一种皮肤拉伸装置，由硅胶带和塑料塞组成，可使伤口边缘靠拢并便于二期延迟缝合。我们描述了过去12年中在5例患者（4例男性）身上使用ETE的经验，这些患者共有8处伤口（7处筋膜切开术后伤口，1处软组织缺损）。患者平均年龄为32岁（范围17 - 61岁）。3例患者的伤口位于下肢，2例位于上肢，其中受伤动脉为腘动脉的3例，腋动脉的1例，肱动脉的1例。伤口平均长度为24厘米（范围9 - 37厘米），每个伤口使用ETE硅胶带的平均数量为13条（范围5 - 19条）。ETE治疗的中位持续时间为7天（范围4 - 7天）。ETE治疗使伤口充分靠拢，8处伤口中有7处得以用传统缝合完全闭合。其中1处发生感染，需要引流、清创和再次缝合。所有伤口均达到满意的愈合状态，所有肢体均得以保全。总之，ETE是一种有用、易用且简单的辅助工具，可促进四肢复杂血管创伤后大面积筋膜切开术后伤口或广泛皮肤及软组织缺损的二期延迟缝合。
