Closure of Fasciotomy Wounds: A Prospective, Observational Study of a Continuous External Tissue Expander
| Status: | Terminated |
|---|---|
| Conditions: | Hospital, Pain |
| Therapuetic Areas: | Musculoskeletal, Other |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 1/31/2018 |
| Start Date: | July 2010 |
| End Date: | February 2014 |
Fasciotomy wounds are rarely able to be closed at the time of index surgery. They often
require multiple returns to surgery for closure, and occasionally require skin grafting (i.e.
they are never completely closed). We are interested in seeing whether this device, which
provides constant and gradual tension on the wound, may allow for rapid wound closure in a
safe fashion, perhaps even precluding a return trip to surgery.
Null hypothesis #1: The Dermaclose Wound Management System (Woundcare Technologies Inc,
Chanhassen, Minnesota) will not result in closure of fasciotomy wounds more rapidly than
standard vessel loop techniques.
Null hypothesis #2: The Dermaclose Wound Management System will not reduce the number of
return trips to the operating room for surgical procedures related to closure or skin
grafting of fasciotomy wounds.
require multiple returns to surgery for closure, and occasionally require skin grafting (i.e.
they are never completely closed). We are interested in seeing whether this device, which
provides constant and gradual tension on the wound, may allow for rapid wound closure in a
safe fashion, perhaps even precluding a return trip to surgery.
Null hypothesis #1: The Dermaclose Wound Management System (Woundcare Technologies Inc,
Chanhassen, Minnesota) will not result in closure of fasciotomy wounds more rapidly than
standard vessel loop techniques.
Null hypothesis #2: The Dermaclose Wound Management System will not reduce the number of
return trips to the operating room for surgical procedures related to closure or skin
grafting of fasciotomy wounds.
After IRB approval, all patients meeting inclusion criteria and requiring fasciotomy of the
arms, legs, or pelvis will be consented for participation in the research study. Patients
will either have their fasciotomy wounds closed through application of the Dermaclose device,
as per the manufacturer's instructions, or through application of vessel loops with staples
in a "shoestring technique" as described in the literature (1). Choice of wound closure
technique will be at surgeon discretion. All patients will undergo application of a
vacuum-assisted wound closure device (Wound VAC, Active Healing Solutions Inc, San Antonio,
TX), which is standard of care for temporary coverage of open wounds (2, 3). Patients will be
returned to the operating room every 2-3 days until wound closure or skin grafting has been
accomplished. If skin closure is not accomplished in the operating room, but occurs prior to
return trip to the operating room, then definitive suture closure of the wound will be
performed under local anaesthetic, followed by removal of the Dermaclose device or of the
vessel loop with staple shoestring. Decisions regarding wound closure or skin grafting in the
operating room will be left to the judgment of the attending surgeon.
arms, legs, or pelvis will be consented for participation in the research study. Patients
will either have their fasciotomy wounds closed through application of the Dermaclose device,
as per the manufacturer's instructions, or through application of vessel loops with staples
in a "shoestring technique" as described in the literature (1). Choice of wound closure
technique will be at surgeon discretion. All patients will undergo application of a
vacuum-assisted wound closure device (Wound VAC, Active Healing Solutions Inc, San Antonio,
TX), which is standard of care for temporary coverage of open wounds (2, 3). Patients will be
returned to the operating room every 2-3 days until wound closure or skin grafting has been
accomplished. If skin closure is not accomplished in the operating room, but occurs prior to
return trip to the operating room, then definitive suture closure of the wound will be
performed under local anaesthetic, followed by removal of the Dermaclose device or of the
vessel loop with staple shoestring. Decisions regarding wound closure or skin grafting in the
operating room will be left to the judgment of the attending surgeon.
Inclusion Criteria:
- Patients 18 years of age or older
- Patients undergoing fasciotomy for decompression of compartment syndrome, evolving
compartment syndrome, or prophylactically to prevent compartment syndrome
Exclusion Criteria:
- Patient younger than 18 years of age
- Patients with an active infection
- Patients unable to comply with protocol
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