Authors
Zelyanin A.S.1, Ivashkin A.N.1, Malofey A.M.1, 2, Saburova T.V.1, Shapilov A.K.1
1 Voronovskoye City Clinical Centre, Moscow
2 Pirogov National Medical and Surgical Center, Moscow
Abstract
The elimination of extensive soft tissue defects resulting from high-energy trauma or injuries is a complex and urgent task of modern surgery. In most cases, soft tissue deficiency does not allow the wound to be closed initially, and spontaneous healing is a lengthy process that is associated with the development of various complications. Traditional methods of autoplasty using microsurgical techniques, including vascularized grafts, require specialized tools, differ in technical complexity and the duration of the surgical aid. The most affordable alternative in different phases of the wound process for deep and extensive wound defects is increasingly the use of a method of controlled increase in skin surface area by mechanical stretching or the method of metered tissue distraction (MMTD).
The article presents a clinical observation using MMTD in its own modification as the first stage of reconstructive and restorative treatment.
Keywords: dermotension, metered tissue distraction, upper limb, wound closure, skin defect, high-energy trauma.
References
1. Dorokhov AE, Akperova SR., Prosvetov S. Analysis of the nature of injuries suffered during a special military operation. Molodeznyj innovacionnyj vestnik. 2023; 12(S2): 138-140. (In Russ.)
2. Vasilyeva LS, Slivnitsyna NV., Shevchenko OI, et al. Clinical and psychological features of combined trauma in participants of military actions. Polytrauma. 2024; 2: 55-61. (In Russ.)
3. Pyatakov SN, Zavrazhnov AA, Pyatakova SN, Soldatov AA. Treatment of extensive abdominal wall defects n mine-blast wound using the method of dosed expansion of soft tissues. Polytrauma. 2017; 4: 31-37. (In Russ.)
4. Guseynov AG, Guseynov AG, Guseynov AA, Suleymanova TB. Ways to optimize wound healing in the treatment of gunshot fractures of the lower extremities. Practical medicine. 2022; 4: 24-30. (In Russ.) doi: 10.32000/ 2072-1757-2022-4-24-30.
5. Izmailov SG, Lukoyanychev EE, Izmailov AG. Technical support for mechanical treatment of problematic soft tissue wounds. Bulletin of Pirogov National Medical & Surgical Center. 2023; 18(1): 145-152. (In Russ.) doi: 10.25881/20728255_2023_18_1_145.
6. Bogdanov SB., Mukhanov ML, Kurinny SN, et al. Skin-fatty flap of anterior abdominal wall for acute injury of upper extremities. Plastic Surgery and Aesthetic Medicine. 2024; 4: 51-59. (In Russ.) doi: 10.17116/plast.hirurgia202404151.
7. Pyatakov SN., Baryshev AG., Mukhanov ML, et al. A case of successful use of a new device for dosed stretch of soft tissue in the treatment of a victim with an extensive post-traumatic wound defect of the leg. Polytrauma. 2024; 3: 84-89. (In Russ.)
8. Wang G, Zhang X, Zhang Z, Wei Z. Clinical study on a skin stretching technique with adjustable external fixators to treat skin defects. Medicine (Baltimore). 2020; 99(37): e22144. doi: 10.1097/MD.0000000000022144.
