A Prospective Evaluation for a Possible Safe Skin Bridge in Elective Foot Surgery

Area of Science:

• Orthopedic Surgery
• Wound Healing Research
• Surgical Technique Optimization

Background:

• Adequate surgical exposure in foot and ankle procedures often necessitates multiple incisions, creating skin bridges.
• Narrowing skin bridges may compromise wound edge vitality and healing potential.
• The specific role of skin bridge width in surgical wound healing remains under-investigated.

Purpose of the Study:

• To investigate the relationship between skin bridge width and wound complications in elective foot and ankle surgery.
• To determine if a minimum safe skin bridge width can be recommended for surgical practice.

Main Methods:

• Prospective study of 60 elective foot surgeries in 56 patients.
• Recording of incision lengths and distances between incisions.
• Assessment of wound complications at 2, 4, and 6 weeks post-surgery, alongside documentation of patient demographics and risk factors.

Main Results:

• Average skin bridge width was 3.9 cm (range: 2-6.8 cm).
• Overall wound complication rate was 8.3% (5/60 feet).
• No significant association found between skin bridge width (≥2 cm) and wound complications when surgical technique and host factors were optimized.

Conclusions:

• Skin bridges of 2 cm or larger did not correlate with increased wound complications in this cohort.
• Meticulous surgical technique and optimized host risk factors appear crucial for successful wound healing.
• Further research with larger cohorts may be beneficial to confirm these findings.