Percutaneous Mesh Expansion: A Regenerative Wound Closure Alternative
Kimberly S Khouri1,2, Eufemiano Cardoso1,2, Roger K Khouri1,2
1New York, N.Y.; and Miami, Fla.
Plastic and Reconstructive Surgery
|October 17, 2017
Summary
Percutaneous mesh expansion uses tiny punctures to create tissue for wound closure, offering a scarless healing method. This technique successfully closed complex calvarial defects in elderly patients with minimal complications.
Area of Science:
- Regenerative Medicine
- Minimally Invasive Surgery
- Tissue Engineering
Background:
- Small puncture wounds typically heal without scarring.
- Stacking punctures enables scarless tissue generation via mesh expansion.
- Percutaneous mesh expansion (PME) is a novel technique for wound closure.
Purpose of the Study:
- To present the experience of applying PME for wound closure.
- To evaluate the efficacy and safety of PME in complex wound cases.
Main Methods:
- PME involves creating staggered rows of punctures using 1.1-mm needles on tissue under tension.
- This technique achieves 20% expansion of the meshed area, generating tissue for defect coverage.
- Closure is performed with sutures or staples after tension release, avoiding undermining or additional incisions.
Main Results:
- All 67 calvarial defects healed with a straight scar at 6-week follow-up.
- Larger defects (>5x5 cm) showed some wound healing delay or required skin grafts.
- No other complications were observed in the study cohort.
Conclusions:
- PME is a minimally invasive procedure that utilizes natural tissue regeneration.
- The technique expands tissue across small gaps, enabling closure of complex wounds without flaps.
- PME offers a scarless approach to wound closure by harnessing the body's regenerative capacity.
