Application of a dynamic wound closure device in orthopaedic trauma patients following fasciotomy: A level-1 trauma center perspective and preliminary case series

Abstract

The challenge of achieving delayed primary closure of fasciotomy wounds is well known, and multiple techniques of achieving either delayed primary closure or alternative forms of soft-tissue reconstruction have been described in the literature. However, a universally accepted consensus of the optimal management strategy has yet to be established. We describe our experience with a device designed to use the mechanical concept of dermatotraction—a surgical technique that uses the skin's natural elasticity to close wounds. This device (ABRA Surgical, Southmedic, Inc) promotes a delayed primary wound healing environment and facilitates dynamic approximation of wound edges in complex fasciotomy defects. During ward-based dynamic closure fasciotomy defects transition to a state where primary closure is safely achievable. This avoids the need for soft-tissue reconstruction which is associated with variable outcomes and cosmetic acceptance. Here, we present our surgical technique and case series using this dynamic closure device.