Findings from a recent study show that a new minimally-invasive skin-stretching device may be a promising alternative for the surgical treatment of large scalp defects.
The study was published in The Journal of Craniofacial Surgery.
Scalp defects caused by trauma or surgical removal of portions of the scalp frequently represent a challenging reconstruction, the study authors note. For large defects that cannot be closed directly, reconstruction usually involves skin grafts, local or free flap transfer technique, scalp expansion, or other procedures. Those treatment methods have disadvantages such as long treatment times and complicated operations under general anesthesia.
In this paper, the investigators report their experience with a new skin-stretching device, the EASApprox, for large scalp defects.
A total of 12 patients with scalp defects treated with the skin-stretching device from Jan. 2020 to Jan. 2021 were included in this study. Of those, six patients had scalp wounds due to pressure ulcers, three had avulsion trauma, and three had poorly healed incisions.
Each patient underwent three to five stretching cycles. Cycles involved no more than 3 kg of tension applied for four minutes and released for one minute. The procedures were done under local anesthesia and the average total operating time was approximately 45 minutes.
For 10 of the patients, the stretching provided enough skin for their wounds to be closed directly using sutures. The remaining two cases were allowed to heal gradually with regular dressing changes. All but one of the scalp defects healed successfully, in an average of roughly two weeks. The last patient experienced complications due to infection, which the authors said was related to immobility and poor nutrition.
A final evaluation of the outcomes showed good skin colour and elasticity with acceptable levels of scarring. The researchers found no serious complications after three months of follow-up.
While the researchers emphasize more clinical and preclinical studies are needed for this approach, they conclude that “treatment [using the] skin-stretching device was effective for scalp defect and has the advantages of convenient operation, acceptable functional results, without severe complications.”