A novel skin-stretching device for closing large skin-soft tissue defects after soft tissue sarcoma resection
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(2020) 18:247
RESEARCH
Open Access
A novel skin-stretching device for closing large skin-soft tissue defects after soft tissue sarcoma resection Qiang Wu1†, Zengwu Shao1†, Yubin Li2, Saroj Rai3, Min Cui1, Ying Yang4 and Baichuan Wang1*
Abstract Background: Closure of large skin-soft tissue defects following soft tissue sarcoma (STS) resection has been a great challenge. The objective of this study was to evaluate the effectiveness of a novel, simple, and cheap skin-stretching device (bidirectional regulation-hook skin closure system, BHS) for closing large skin-soft tissue defects resulting from the removal of STS and the complications associated with the use of the BHS. Methods: From January 2017 to September 2018, 25 patients with STS underwent BHS therapy after tumor resection. BHS was used for two main clinical applications: securing wound closure after high-tension suture closure and delayed wound closure. We described a detailed reconstruction procedure regarding this therapy. Wound closure and complications associated with BHS therapy were recorded. We also analyzed tumor recurrence and metastases. Results: All patients were observed for 16–36 months with an average follow-up of 25.6 months. During the follow-up period, no significant functional restriction was observed and the final scar was aesthetically acceptable. Superficial wound infection occurred in six patients, wound edge ischemia in two patients, and small skin tears in two patients. Two patients developed pulmonary metastasis, two patients had a local recurrence, and one patient died of pulmonary metastasis. Conclusions: BHS therapy can effectively close large skin-soft tissue defects following STS resection and obtain acceptable functional results, without severe complications. However, larger studies are required to further evaluate the effectiveness, indications, and complications of BHS therapy. Keywords: Soft tissue sarcoma, Radical resection, Tissue expansion, Tension suture, Complications
Introduction Soft tissue sarcoma (STS) is an uncommon malignant tumor that originates from primitive mesenchymal tissue. At present, treatment of STS is a multimodal therapy that involves surgical resection, chemotherapy, and radiotherapy [1]. Among these, surgical resection is the mainstay of therapy. However, it frequently results in large skin-soft
* Correspondence: [email protected] † Qiang Wu and Zengwu Shao contributed equally to this work. 1 Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China Full list of author information is available at the end of the article
tissue defect and exposure of vital structures because of the wide margins that need to be taken. Closure of large skin-soft tissue defects following STS resection is a common reconstructive challenge. Primary closure of wounds with conventional suturing techniques is usually the optimal solution because of its simplicity and acceptable outcomes, yet it is often limited, particularly with regard
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