Fascial and peri-incision cutaneous meshing for complex soft tissue closure

Abstract

Obtaining primary closure of the soft tissue envelope in complex wounds can pose significant challenges to the surgeon. Excess tension across the proposed line of closure and peri-incisional skin is common when closing complex defects. This may result in wound dehiscence or suture line and adjacent skin necrosis; potentially resulting in a soft tissue problem worse than the index defect. Soft tissue compromise can be followed by infection which places underlying vital structures and implants at risk. Techniques to reduce tension include skin meshing and the use of gradual mechanical assisted closure. Secondary wound closure techniques possess inherent risks and mechanical assisted techniques are prone to technical failure or are suited for only small wounds. This paper describes a perforator sparing deep fascia meshing technique (Bibbo Perforator Sparing Deep Fascial Meshing Technique) to assist with obtaining immediate primary closure of complex wounds. This technique allows for closure of wounds that would require a secondary closure procedure or skin grafting.

Keywords

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