Dermotaxis v/s Loop Suture Technique for Closure of Fasciotomy Wounds : a Study of 50 Cases
Condition: Inexpensive Closure of Fasciotomy Incisions Without the Need for Skin Grafting
MeSH terms: Surgical Wound
Study type: Interventional

Summary: 
      The fasciotomy incisions lead to large, unsightly, chronic wounds after surgical
      intervention. The classic management was split thickness skin grafting but it leads to
      insensate skin with 23% of people upset by the appearance of the wound and 12% forced to
      changed occupation. Since no skin loss has occurred with the fasciotomy and utilizing the
      dermal properties of creep, stress relaxation and load cycling closure can be achieved in a
      better way. Our hypothesis is that using dermatotraction approximation could be done using
      inexpensive equipment readily available in any standard operating room.
    

Detailed description: 
      25 cases each of fasciotomy will be closed either by dermotaxis or loop suture technique with
      the inclusion criteria being closed fractures, no concomitant skin loss, fracture related
      compartment syndrome and fasciotomy within 36 hrs. The fasciotomy incision will be either
      closed in a single stage by loop suture technique or gradually by dermotaxis once the edema
      settled between 3-5 days. The results will be graded as excellent if approximation could be
      achieved, good if sutures have to be applied for protective care and poor if they have to be
      grafted. In dermotaxis (Singhs skin traction) method two parallel kirschner wires (1.5mm)
      will be passed through the dermis on either side of the wound margins and interconnected by
      compression device consisting of threaded rod having two blocks and compression knob. Gradual
      compression will be applied daily at the rate of 1 turn/12hours on both sides of the wound.

      The loop suture technique involves using corrugated drains and Ethilon no.1. It is an
      extension of the purse string suture technique where a surgical suture is passed as a running
      stitch in and out along the edge of a wound in such a way that when the ends of the suture
      are drawn tight the wound is closed. Two corrugated drains (1 & 2) will be anchored to the
      skin adjacent to the fasciotomy incision using Ethilon no.1. Then the sutures will be passed
      from one edge of the wound through the skin and corrugated drain to the other in an
      alternating fashion.
    

Intervention name(s): dermotaxis; loop suture technique
Intervention type(s): Procedure; Procedure
Intervention description(s): In dermotaxis (Singhs skin traction) method two parallel kirschner wires (1.5mm) will be passed through the dermis on either side of the wound margins and interconnected by compression device consisting of threaded rod having two blocks and compression knob. Gradual compression will be applied daily at the rate of 1 turn/12hours on both sides of the wound.; The loop suture technique involves using corrugated drains and Ethilon no.1. It is an extension of the purse string suture technique where a surgical suture is passed as a running stitch in and out along the edge of a wound in such a way that when the ends of the suture are drawn tight the wound is closed. Two corrugated drains (1 & 2) will be anchored to the skin adjacent to the fasciotomy incision using Ethilon no.1. Then the sutures will be passed from one edge of the wound through the skin and corrugated drain to the other in an alternating fashion.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: inexpensive, fasciotomy