New skin-stretching mechanism closes wounds for faster healing
Technology is painless and safe to use on children and animals.
A new stretching device considered a breakthrough in surgical care can close wounds without skin grafts or other complex solutions, helping patients heal faster.
The innovation could save the lives of patients who would otherwise die from infections when stitches burst, or help them avoid much more complex procedures, such as skin grafts and plastic surgery.
Other devices on the market use surgical pins at the edge of wounds to apply tension and often rip the skin, Dr. Moris Topaz, an Israeli plastic surgeon who invented the technology, told From The Grapevine.
“With TopClosure you can apply very high tension to the skin, spread over a large area, far away from the wound edges,” said Topaz, who is head of the plastic surgery unit at Hillel Yaffe Medical Center in Israel.
TopClosure is meant as a stopgap measure in cases that don’t respond to conventional wound care. Most complex wounds still require further surgery. The technology has applications in various medical specialties including trauma, emergency, orthopedics, oncology, vascular and even pediatrics and veterinary medicine. “It doesn’t hurt because you apply it to a wide area,” said Topaz. In one of its more unusual uses, for instance, the company donated its device to help repair the shell of a Caspian turtle at the Ramat Gan Safari in Israel. A more typical use would be a gash to the face or head.
Topaz compares one way of using the device to pregnancy, where the skin stretches slowly over time. “Day by day it stretches a huge gap. This is exactly what we do with tissue expanders. The idea is to do it a different way, hold the skin with plates, protect the skin from damage and slowly stretch the skin like during pregnancy prior to surgery.” Then, during surgery, the skin is stretched much faster, Topaz said.
As the skin is stretched, the device acts like a tissue expander and a zipper, allowing medical staff to reopen the wound as needed for further evaluation, to treat for infection and to help it heal, he said.
The technology has been cleared by the U.S. Food and Drug Administration and its European counterpart. So far, it’s been used in China and India, where Topaz has taught or performed surgery, and over the past year in Puerto Rico.
TopClosure offers a more economical and effective alternative to skin grafts or flaps – taking skin from one area to another – or tissue expanders used to stretch the skin under the surface, Dr. Norma Cruz, a plastic surgeon in Puerto Rico, told From The Grapevine. It has helped her patients avoid costly surgery and speed their recovery.
“It’s a low-tech, low-budget solution to a very complex problem,” said Cruz, who is chief of plastic surgery at the University of Puerto Rico’s medical school and one of the first device users.
“In the specialty of plastic and reconstructive surgery, one often faces the need to close large soft-tissue defects,” she said. “Using the elastic properties of the skin in a safe and reliable manner, primary closure is possible, even in large defects. Surgical procedures are shorter, patients can be ambulatory and wound care can be performed on an outpatient basis.”
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