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Semin Plast Surg 2022; 36(02): 083-088
DOI: 10.1055/s-0042-1748915
Review Article

Pediatric Wound Closure by a Tension-Relief System

Dafna Shilo Yaacobi
1   Department of Plastic Surgery & Burns, Rabin Medical Center – Beilinson Hospital, Petach Tikva, Israel, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
,
Moris Topaz
2   IVT Medical Ltd., Ra'anana, Israel
,
Eyal Kalish
1   Department of Plastic Surgery & Burns, Rabin Medical Center – Beilinson Hospital, Petach Tikva, Israel, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
3   Plastic Surgery & Burns Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
,
Yehiel Hayun
1   Department of Plastic Surgery & Burns, Rabin Medical Center – Beilinson Hospital, Petach Tikva, Israel, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
,
Michael Gurevich
4   Department of Transplantation, Rabin Medical Center- Beilinson Hospital, Petach Tikva, Israel, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
,
Dean Ad-El
1   Department of Plastic Surgery & Burns, Rabin Medical Center – Beilinson Hospital, Petach Tikva, Israel, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
,
Andrew E. Grush
5   Michael E. DeBakey Department of Surgery, Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas
6   Department of Surgery, Division of Plastic Surgery, Texas Children's Hospital, Houston, Texas
,
Asaf Olshinka
1   Department of Plastic Surgery & Burns, Rabin Medical Center – Beilinson Hospital, Petach Tikva, Israel, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
3   Plastic Surgery & Burns Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Abstract

Surgical reconstruction in pediatric patients can often be complex. Primary wound closure is almost always the preferred technique in the reconstructive ladder; however, it is not always possible in pediatric patients. We report the pediatric use of the TopClosure Tension-Relief System, an innovative skin-stretching technique for secure primary wound closure of large defects. We modified the technique by fixating it to a protective dressing instead of the patient's skin, thus avoiding both staple scars and pain. A retrospective review of 112 patients aged 7 days to 18 years who underwent Tension-Relief System-assisted surgery at a tertiary medical center from 2010 to 2020 was conducted. Cases included congenital deformities, traumatic wounds, burn scars, and complicated-wounds, with or without hardware or deep tissue exposure. The use of the system avoided the need for multiple surgical sessions and for local or regional flaps. The technique was simple to use, with few complications, and led to satisfactory aesthetic and functional outcomes. The findings support using the technique in children and adolescents with challenging tension wounds. Herein, we report on our experience with the Tension-Relief System and detail four cases in which early or immediate closure was successfully achieved.

Keywords

Tension-Relief System - pediatric tension wound - TopClosure for pediatric use - challenging pediatric wounds

Products / Devices / Drugs: Disclosure: Moris Topaz, MD, PhD, is the inventor of the TopClosure® system and CEO of IVT Medical Ltd., which manufactures the device.




Publication History

Article published online:
02 July 2022

© 2022. Thieme. All rights reserved.

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