TENSION-RELIEVING TECHNIQUES

SKIN STRETCHERS

Skin stretchers enhance skin extensibility by utilizing the biomechanical properties of skin such as mechanical creep and stress relaxation. Mechanical creep is the capability of skin to stretch beyond its limits of inherent extensibility as collagen fibres align and displace the interstitial fluid surrounding collagen fibres and fibrils. Stress relaxation is a progressive reduction in the force required to maintain a length of stretched skin. Skin stretching using velcro pads and strips is a covenient and inexpensive technique to stretch skin to facilitate the closure of large skin defects.

PRESUTURE

Presuturing involves the placement of sutures in the skin adjacent to a tumor 2-4 days prior to definitive surgical excision. Presuturing relies on the inherent biomechanical properties of skin (such as creep and stress relaxation) to stretch beyond its normal elasticity. Presutures are associated with a 40.1% decrease in the force required to close simple wounds in pigs.

RELEASING INCISIONS

Releasing incisions are a surgical technique used to decrease tension on wounds which are close to being apposed primarily but for which closure may result in impaired circulation. Releasing incisions can be a simple relaxing incision, bipedicle flap, or multiple punctate relaxing incisions.

Last updated on 6th March 2017