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Decrease in skin-closing tension intraoperatively with suture tension adjustment reel, balloon expansion, and

A C Lam1, Q H Nguyen, D P Tahery

  • 1Division of Dermatology, University of California Los Angeles 90024.

The Journal of Dermatologic Surgery and Oncology
|June 1, 1994
PubMed
Summary
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The S.T.A.R. device most effectively reduces skin closing tension in surgical defects. This method, along with undermining, offers synergistic benefits for wound closure, improving surgical outcomes.

Area of Science:

  • Biomedical Engineering
  • Surgical Innovation
  • Dermatology

Background:

  • Skin exhibits biomechanical and viscoelastic properties, including mechanical creep, enabling significant stretching.
  • Mechanical creep is utilized in surgical techniques for closing large defects intraoperatively.
  • The S.T.A.R. (Suture Tension Adjustment Reel) device allows precise load application and tension measurement for surgical defects.

Purpose of the Study:

  • To compare the efficacy of linear load cycling using the S.T.A.R. device, spherical load cycling with a balloon expander, and surgical undermining.
  • To evaluate the impact of these methods on the closing tension of surgical defects.

Main Methods:

  • Surgical defects were created on the flanks of six pigs.
  • Defects were repaired using undermining, balloon expander, and the S.T.A.R. device.

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  • The combined effect of undermining and the S.T.A.R. device was also assessed.

    • Main Results:

    • Surgical undermining decreased skin closing tension by an average of 17.8%.
    • Balloon expander use resulted in an average decrease of 28.5% in closing tension.
    • The S.T.A.R. device achieved the largest average decrease in closing tension, 36.6%.

    Conclusions:

    • All tested techniques effectively reduced the tension required for surgical defect approximation.
    • The S.T.A.R. device demonstrated the greatest effectiveness in lowering skin closing tension.
    • A synergistic effect was observed when combining undermining with the S.T.A.R. device, further reducing skin closing tension.