Wound Closure With Acute Dermatotraction

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Many described techniques take advantage of the viscoelasticity of the human integument to assist in primary closure of fasciotomy wounds. A retrospective chart review was performed on eight patients with a total of 17 incisions who underwent fasciotomy for acute compartment syndrome. Wounds were closed with delayed primary closure (DPC). Patients were males with a mean age of 40 years (range, 21–64). Fasciotomy mean wound length and width at attempted closure was 16.1 š 6 cm and 6.3 š 2 cm, respectively. Mean time to closure after fasciotomy was 3.9 days (range, 2–8). All wounds healed, at a mean of 18.3 š 2.6 days. Patients were followed for a mean of 21 weeks (range, 3–52). The described novel sequential suturing technique can achieve closure with low risk of major complications; 100% wound healing was achieved. When used judiciously, the technique presented can achieve reliable results in selected fasciotomy wound healing. (Journal of Surgical Orthopaedic Advances 27(2):155–159, 2018)
Keywords: acute wounds, compartment syndrome, delayed primary closure, dermatotraction, fasciotomy closure

James W. Barnes, MD; Garth Sherman, BS; and Jonathan Dubin, MD