Acute tissue expansion by pretaping to achieve elliptical excision and closure for skin tumours and soft tissue tumours
- 5 Downloads
An elliptical excision of skin for treating a tumour is technically simple. Our objective was to recruit lateral laxity by stretching the skin prior to surgical excision of a tumour. A retrospective cohort of 20 consecutive patients who were treated with pretaping over a period of 7 years is presented. The surgeon used pretaping in patients with skin and soft tissue tumours where the pinch test for the planned ellipse failed to simulate easy closure. Data collated and analysed included patient demographic profile, tumour profile, parameters associated with pretaping and clinical outcome. A descriptive account demonstrating the technique is provided. The average age in the cohort was 44 years. The sample represents 24 sets of pretaping applications prior to 24 excisions. Twenty-three (96%) of these were performed on limbs. The 24 lesions treated were made up of five melanomas, 16 non-melanoma cutaneous neoplasms and three soft tissue sarcomas. The total time period of each set of applications per lesion varied from 15 min to 26 days. The mean width of the ellipse removed was 27 mm for cutaneous neoplasms (n = 21) and 84 mm for soft tissue sarcomas (n = 3). The pretaping allowed for simple direct wound closure with healing in all cases. Pretaping applied for as little as 30 min to several days prior to surgery can, within limits, expand skin tissue to achieve simple skin closure following elliptical excision of skin and soft tissue tumours in patients that would otherwise require skin grafting or skin flaps.
Level of Evidence: IV Type of Study: Therapeutic
KeywordsSkin tumours Soft tissue sarcoma Tissue expansion Traction-assisted tissue expansion Presuturing Pretaping
This study is part of my PhD Thesis. I will like to acknowledge my supervisors Colleen Aldous and Dennis P. Orgill of Division of Plastic Surgery, Brigham and Women’s Hospital and Dana Farber Cancer Institute, Boston, MA., for their contributions.
Compliance with ethical standards
Conflict of interest
M. Daya and C. Aldous declare that they have no conflict of interest.
Approval number BE291/13 was obtained from the university’s Biomedical Research Ethics Committee.
For all patients included in the study, written informed consent for surgical procedure and the associated pretaping was obtained.
- 16.Ruizmaldonado R, Carbajosa J (1994) Closure of medium-size surgical skin wounds with evaginated presuturing. Eur J Dermatol 4(5):362–364Google Scholar
- 18.Rao AL, Janna RK (2015) Keystone flap: versatile flap for reconstruction of limb defects. J Clin Diagn Res 9(3):05–07Google Scholar
- 23.Chandawarkar RY, Cervino AL, Pennington GA (2003) Intraoperative acute tissue expansion revisited: a valuable tool for challenging skin defects. Dermatol Surg 29(8):834–838Google Scholar
- 24.Sanders JE, Goldstein BS, Leotta DF (1995) Skin response to mechanical stress: adaptation rather than breakdown-a review of the literature. J Rehabil Res Dev 32(3):214–226Google Scholar