Wound management by constant tension approximation.

An ideal result in wound healing is expedited closure with full-thickness skin, as opposed to thin, fragile epithelium prone to future breakdown. To help achieve accelerated healing by full thickness skin, a device has been designed that applies constant tension traction to the wound margins. The device acts by both approximating the wound and by encouraging tissue and skin generation through stimulating angiogenesis and epithelial proliferation. This study includes 31 patients with 36 wounds of varying etiologies treated over 28 days. The wounds were inspected every 3 to 5 days at which time the dressings were changed and new devices applied, as needed. All but five of the wounds healed completely with full thickness skin within the study period (average: 15 days; range: 7-28 days). The longest healing times occurred in the patients with pressure ulcers. Using a formula for determining healing time based on excisional wound dimension, the expected healing time of a 3cm wide foot ulcer with uninterrupted progress is 41 days. The time for such a wound to heal in this study was 21 days. The approximating device accelerated wound healing by full thickness skin for the wounds included in this study. Other considerations when using this method include cost, patient compliance and indications/contraindications.