Strich R, Böhm H J
Berufsgenossenschaftliche Unfallklinik Duisburg-Buchholz.
Swiss Surg. 1995(5):236-40.
Dynamic skin suture exerts progressive traction to the wound margins which allows a stepwise closure of a defect. It consists of interrupted sutures with two additional plastic tubes lying parallel to the wound margins on the surface of the skin. The extracuticular slopes of the sutures and the knots pass over these tubes. This decreases local pressure on the skin. The knots are performed in a way that, once they have been tied, permits further tightening without opening them. A viscoelastic property of the skin--stress-relaxation- reduces the tension on the sutures over time and allows a further tightening. As an example for the use of this technique, the results of closures of fasciotomies in compartment syndromes are presented. In 1993, 50 fasciotomies in 35 patients were treated with dynamic suture. In 42 defects (84%) a complete obliteration was possible. In the residual 8 defects reduction of size was significant. The mean time until obliteration was 11.5 days, in average sutures were tightened 4 times. The results suggest that dynamic suture is a useful technique for repair in fasciotomies. It helps avoiding tissue transplantations. The operative procedure itself is speedy and simple. Possible indications in limited excisional defects are demonstrated in a case report.
动态皮肤缝合对伤口边缘施加渐进性牵引力，从而实现缺损的逐步闭合。它由间断缝合线组成，在皮肤表面有两根平行于伤口边缘的附加塑料管。缝合线的皮外斜坡和结越过这些管子。这降低了皮肤局部压力。打结的方式是，一旦打结，在不解开的情况下允许进一步收紧。皮肤的一种粘弹性特性——应力松弛——会随着时间的推移降低缝合线上的张力，并允许进一步收紧。作为该技术应用的一个例子，展示了骨筋膜室综合征切开减压术后伤口闭合的结果。1993年，35例患者的50处切开减压术采用了动态缝合治疗。在42处缺损（84%）中实现了完全闭合。在其余8处缺损中，尺寸缩小显著。平均闭合时间为11.5天，平均缝合线收紧4次。结果表明，动态缝合是一种用于切开减压术修复的有用技术。它有助于避免组织移植。手术操作本身快速且简单。一份病例报告展示了在有限切除性缺损中的可能适应症。
