To explore in scar management the therapeutic effect of applying paper tape in skin tissue expansion. Serial applications of the tape to the skin produced traction-assisted tissue expansion (TATE) (formerly referred to as traction-assisted dermatogenesis) for scar regrowth.
Introduction
Some of the disadvantages of the procedure include failures, complications, and the need for training and skill development in planning and executing tissue expansion. ). Negative pressure wound therapy has been extensively studied.(41) Sponge collapse accompanied by suction application results in immediate wound contraction.
Cellular and Biochemical response of Skin, Wounds and Scars to Mechanics of Traction
Mechanobiolology of Traction Assisted Tissue Expansion, Traction Assisted Closure and
Forces applied to the epidermis are transmitted via this network as it deforms in response.(2) The underlying dermis consists mainly of the structural protein collagen in an extracellular matrix. Many different types of devices have been used for the purposes of achieving tissue expansion in an external manner.(71-74) The most important advantage is that they are used in open wounds of the skin.
Clinical Application of Taping of the Skin in Plastic and Reconstructive Surgery to Achieve
Traction Assisted Dermatogenesis by Serial Intermittent Skin Tape application. Daya
The area of the scar to be overlapped with the surrounding normal skin is marked (Figure 1a). In the initial part of the study, the patients were prepared and photographed by a doctor. This patient, a twelve-year-old girl, suffered a full-thickness scalp burn at 1 year of age (Figure 2a).
A skin grafted area on the forearm appears 1 week after the first tape application. The expansion failed to progress satisfactorily in the last part of the 10 taping sessions (figure 8b). The distribution and size of the burn scar on the scalp and forehead should be noted.
Elevated hypertrophic scars also impede the migration of the surrounding skin over the scar (Figure 6a). His point about using excessive tension when applying tape was important. The DynaClose device has been proven to apply to a wide area of adjacent skin.
Excision and Reconstruction Following use of Paper Tape Application in Skin Tissue
Treatment in the neonatal period includes curettage, dermabrasion and laser resurfacing aimed at removing the pigmented part of the skin. The skin was clamped vertically and folded in the midline of the back recruiting the immediate lateral laxity in the skin and held in place by the application of paper tape^ (Figure 2). The outline in the reduction of the folded size of the nevus can be seen through the tape.
The relative size of the lesion to the surrounding normal skin in the various anatomical regions of the body is another important determinant. The pinch test in the area of the lesion is the surgeon's best tool to assess the rate of tissue expansion and laxity requirements to achieve the reconstructive goals. Large and giant congenital pigmented nevi of the upper extremity: an algorithm for surgical management.
In Chapter 5, the rate at which the expansion of the back skin occurred in the 1-month-old was surprising. In the next chapter, Chapter 6, TATE is used in a 1-year-old child to expand the dorsal skin to repair a recurrent myelomeningocele. With the first application of tape, there was some doubt as to whether TATE would be successful.
Repair of a Recurrent Myelomeningocele associated with an Inclusion Epidermal Cyst
He underwent primary direct MMC repair at four days of age. Healing was uneventful, but a year later a tender swelling appeared in the area of the previous repair. The overlying skin had vascular staining in the upper portion, and an indentation in the skin was noted in the upper portion of the scar.
The epidermis of the MMC also appeared to be adherent to its underlying sac. The plan was to create skin laxity to enable removal of all the overlying skin and soft tissue of the MMC and. A sinus-like opening could be seen on the surface of the skin at the top of the old scar.
The roof of the MMC sac with all overlying tissue was then excised. The neural placode was released and the dura was mobilized from the lateral sidewalls of the open vertebra. The tissue expansion achieved allowed the surgeon the freedom to remove all soft tissue from the dorsal aspect of the MMC.
Acute Tissue Expansion by Pretaping to Achieve Elliptical Excision and Closure for Skin
On the limb, the longitudinal axis of the ellipse is usually oriented along the long axis. To optimize the skin splinter and the tape adhesion, overlap the tape edge slightly. To maintain the tissue expansion of the skin, taping must continue up to the time of surgery.
A total of 57 mm horizontal width of the skin was removed and primary closed using pretaping. In this series, 2 cases with sarcoma of the femur were treated with the described technique. Although elliptical excision and closure can be simple, the orientation of the ellipse is vital.
They are traction on the skin surrounding the marked ellipse and compression of the ellipse. Use of the anterolateral thigh flap for microsurgical reconstruction of the distal extremities after oncosurgical resection of soft tissue sarcomas. In Chapter 3, the tape was applied to achieve TATE by changing the tape once a week.
The use of Paper Tape Application in Skin Tissue Expansion to Achieve Closure to
A paper tape^ is then placed so that the skin flaps are moved by traction from both sides in the direction of the intended closure (Fig. 1C). The closing line can be varied as the bonding progresses with each application. In three cases, taping was introduced in the acute and subacute phases of wound healing.
Anterior view of leg stump amputation is shown on day 52 after seizure onset. After damaging a 2 cm rim of skin flap, the wound further expanded to 130 mm X 75 mm (right). Rehabilitation of the prosthetic patient depends on good skin and soft tissue quality.
In TATE, using paper tape that covers the wound and migrates the skin toward it, we have seen a rapid reduction in wound size with each episode of tape. Removal of the paper tape between applications did not cause retrograde spread of the wound. Initial bonding also included the use of a wound contact dressing over which microporous tape was applied.
The Successful Application of TATE to Achieve Fasciotomy Closure without Skin
It demonstrates the feasibility of achieving skin tissue expansion with the non-invasive, economical and painless technique of TATE in the preparation of a 2-stage surgical closure of a subacute fasciotomy wound of the forearm achieved over a period of two weeks. (1) the purpose of the study is to share our approach by adding to the techniques already described in the literature on the treatment of limb fasciotomy wounds. A few hours later the patient developed a compartment tension syndrome of the left forearm due to a hematoma. The patient accepted the use of TATE to achieve delayed primary wound closure.
If it is observed that the wound is exuding, then gauze and an adapter roll are made to cover the central part of the wound (Figure 2). Paper tape^ is applied by migrating the skin sheets with pull from both sides in the direction of the designed closure. It is worth noting that the micropore allows the outflow of edema fluid through the pores of the tape.
On Day 14 the patient was returned to theater for final direct closure of the wound. TATE adequately addressed both the vascular surgeon's and patient's concerns about the exposed tendon and the forearm aesthetics. It imparts forces of deformation and microdeformation that hasten the closure of the wound through accelerated secondary intensive healing.
Traction Assisted Closure with 3M MicroporeTape of a Large Wound Resulting from
Mechanical forces have been recognized in the repair, regulation, and remodeling of tissue growth.(7) The advent of the VAC™ has revolutionized wound management and should not be viewed solely as a dressing. The initial device design concept was primarily aimed at accelerating wound closure through secondary intention healing. A significant disadvantage of the device is cost, therefore its use must be supported by benefits for the wound at various levels.
A randomized experiment in a pig model showed that the extent of wound contraction was site-dependent. (8) The use of micropores then essentially serves as an external splint for the wound, as the collagen framework is laid down and remodeled in an artificially contracted state. TAC is used to care for open wounds and differs in that the wound is closed only with tape. If we find that it is exuding from the wound, we make gauze and an adjusting roll that covers the central part of the wound.
The micropore tape is then applied and the skin flaps migrate by traction from either side in the direction of the projected closure. The primary purpose of the technique is to provide a mechanical tension force on the surrounding soft tissue and draw it into the wound. The skin and the wound after removal of the first application of tape showed a greater degree of deformation to tissue manipulation.
Generation of Mechanical Forces with the Use of Micropore Tape to Modulate Keloids and
Abnormal scar taping can promote scar maturation and control associated symptoms. The efficacy of this treatment and its exact mechanism of action have not really been established. The patient and the body part to be taped were positioned so that tension in the scar area was reduced or eliminated.
We assumed that this maneuver interrupted the transmission of tension from the surrounding tissues to the scar. Also note that the application of the full taping is done after the tension on the scar has been neutralized. Also note the reduction in lesion width, which is in the same direction of tension reduction as achieved by the strip (right).
The purpose of the study was to measure the effect of tension elimination with taping on the abnormal scar. In clinical practice, scar maturation is reflected in a flattened, paler and less shiny scar. Reiffel learned in his clinical series that the direction of tape application and reduction of tension in relation to Langer's line and the scar was important to prevent the formation of hypertrophic scars.
