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Tension decrease during skin stretching in undermined versus not undermined skin: an experimental study in piglets.

P Melis1, M L Noorlander, K E Bos

  • 1Department of Plastic, Reconstructive, and Handsurgery, Academisch Medisch Centrum, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. docmelis@hotmail.com

Plastic and Reconstructive Surgery
|May 25, 2001
PubMed
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Skin stretching significantly reduces wound closing tension, proving more effective than undermining alone. Combining techniques offers minimal extra benefit but increases risks like skin necrosis and seroma formation.

Area of Science:

  • Biomedical Engineering
  • Wound Healing Research
  • Surgical Techniques

Background:

  • Wound closure often involves significant tension, potentially compromising healing.
  • Undermining skin margins is a common technique to reduce tension.
  • The efficacy of mechanical skin stretching as an adjunct or alternative to undermining requires further investigation.

Purpose of the Study:

  • To evaluate the efficacy of a skin stretching device in reducing wound closure tension.
  • To compare the tension reduction achieved by skin stretching versus skin undermining.
  • To assess the impact of these techniques on wound healing and tissue viability.

Main Methods:

  • A controlled study was conducted on 15 piglets with 30 standardized wounds.
  • Wounds were divided into two groups: undermined and not undermined skin margins.

Related Experiment Videos

  • Tension was measured before and after undermining and 30 minutes of skin stretching.

    • Main Results:

    • Skin stretching alone reduced tension by 6.10 N (26.5%), significantly more than undermining alone (3.02 N, 13.6%).
    • Combined undermining and stretching yielded a total tension decrease of 7.60 N (34.1%), with a small additional benefit over stretching alone.
    • Undermining led to skin necrosis (7/15 wounds) and seroma formation, while non-undermined wounds healed without complications.

    Conclusions:

    • Mechanical skin stretching is a highly effective method for reducing wound closure tension.
    • Skin stretching offers significant advantages over undermining, with reduced risks of necrosis and seroma.
    • While combining techniques provides a marginal increase in tension reduction, it introduces complications associated with undermining.