Application of suture-stretching technique in repairing skin defect of lower limb

Background: Wound repair methods are commonly used in clinical practice, such as skin graft and flap repair, which can cause secondary injuries, and high costs. Many methods for skin stretching and repair have been reported domestically and internationally. However, their clinical use is limited owing to lack of equipment, complexity, and high costs. Therefore, we introduce a novel technique to repair wound.

Methods: We collected 125 patients with skin defects of lower limb from January 2019 to June 2024. Among them, 77 cases were repaired using our novel technique (suture-stretching technique, we designed a simple and feasible skin traction device that used 2-0 (polydioxanone sutures) PDS sutures, 2.0 mm Kirschner wires, and nylon binding tapes to repair skin defects and accommodate irregular wounds according to Ilizarov's "tension-stress" law, SS group); skin grafting (SG group) was used for repairing 48 cases of wounds. We collected the data of the two groups, including wound size, number of debridements, operation time, wound healing time, hospital stays, and surgury cost, and the data were analyzed statistically.

Results: There was no statistically significant difference between the two groups in terms of age, gender, wound size and wound healing time (p > 0.05).However, the number of debridements (p < 0.0001), operation time (p < 0.0001), hospital stays (p < 0.0001) and surgery time (p < 0.0001) in the suture group were better than those in the skin grafting group with statistically significant difference.

Conclusion: The application of suture-stretching technique to repair skin defect wounds of lower limb have good clinical efficacy, which can reduce the number of operations, shorten the operation time, and avoid secondary injuries caused by skin graft or skin flaps. Meanwhile, it also has obvious advantages regarding hospital stays and surgery costs.