Skin Stretcher Device Secures Wound Closure

The TopClosure System is comprised of two small (6 cm x 2.5 cm) plastic bases with an adhesive bottom surface which adheres to the skin. The bases are placed facing each other on both sides of the wound, with each perpendicular surface containing a serrated slit through which a plastic ribbon, similar to a tie restraint, is passed. The skin on both sides of the wound is then “zippered up,” and stretched to approximation, until it covers the entire wound. The larger area of contact with the skin reduces the applied tension, leading to wider stress distribution, minimizing tearing or dehiscence, and resulting in better quality and improved aesthetics of the scar.

When the size of the injury is relatively large, several kits may be used together, applying uniform pressure on the skin surrounding the injury. TopClosure can also be attached to the skin invasively, using staples, sutures, or K-wires. The process can also be complimented by other means, such as coagulants, tourniquets, or bandages when treatment delay is projected, such as in battlefield situations that require evacuation. The TopClosure System is a product of IVT Medical (Raanana, Israel), and has been approved by the US Food and Drug Administration (FDA).

“It’s changing the way we’ve been handling the closure of wounds to avoid further damage and contamination to the injured tissues,” said TopClosure inventor plastic surgeon Morris Topaz, MD, director of the Hillel Yaffe Medical Center (Hadera, Israel) plastic surgery unit. “When trying to close a wound with sutures, we apply high tension to the skin. With TopClosure we can spread the tension on the skin about 100,000 times higher than we could do before.”

The need for tension-reduction during wound closure can be addressed using various stretching devices designed to harness the viscoelastic properties of skin by applying controlled and evenly-distributed tension along the wound margins, using incremental traction. But the principle of stretching wound margins is problematic, since it can cause necrosis and tears during approximation of the opposing wound edges, if excessive tension is applied. Additionally, these devices are by nature invasive, bulky, and may damage wound edges.

Related Links:
IVT Medical
Hillel Yaffe Medical Center