2011, Number 3
Cutaneous tensors for closure of pressure sores in difficult cases
Anguiano-Yazbek R, Castillejos-Zenteno L
Full text
Language: Spanish
References: 11
Page: 139-144
PDF size: 107.06 Kb.
ABSTRACT
Pressure ulcers are a preventable condition, but once they occur, the condition requires costly and difficult management. The treatment of choice is the rotation of myocutaneous flaps. When the physical and nutritional conditions of the patient do not allow the performance of these procedures, surgical options are limited. The cutaneous tensor gives us a new possibility for wound closure in difficult cases. We included 12 patients with a total of 17 ulcers with an average age of 56.6 years, ranging from 11 to 75 years who were not candidates for rotation of a myocutaneous flap. The technique is based on traction through skin tensioning, a technique proposed by the author as an alternative when conventional procedures were not possible for these cases. In the first stage, debridement of necrotic tissue is performed, with local anesthesia. In the second, sections of venopunction tube were sutured to the skin, fascia, and muscle at the edges of the wounds, on healthy tissue, with 2-0 propylene, taking all the block layers. Then through the tubes are passed plastic, denticulate clamps and then the clamps are closed, every day there is traction until the wound is faced. In the third, when the ulcer is edge to edge, and enough tissue is gained, direct closure is performed without tension, under local anesthesia. The average time for the closing of the injuries was 34.1 days (4.8 weeks). The average number of closing days for ulcers with a facing closure of 100% was 30.8 days, ranging between 8 and 91 days. The proposed system allows us to have an effective closure of ulcers that are difficult to manage, even when the patient has poor physical and nutritional conditions, with minimal risk, so it is considered an effective alternative in these cases.REFERENCES