New Non-invasive wound closure device or Traditional Wound closure?

With the development of the times, whether it is in the Department of Burns and Plastic Surgery, Department of Traumatology, or General Surgery, patients' treatment of wounds or wounds is not only to stay in the past to achieve the purpose of preventing infection and healing, but also expects to have a good cosmetic effect , rather than scarred wounds.

Normal intact skin is composed of epidermis, dermis, and subcutaneous tissue (see Figure 1). It belongs to a kind of nonlinear viscoelastic material. Viscoelasticity is a kind of mechanical property of material. It not only has the ability of elastic deformation or even plastic deformation, but also has the property of viscous fluid, that is, the strain rate is not zero, and it will change with the development of time. Creep occurs. Based on this principle, medical device practitioners and medical staff in various countries have developed medical products with their own characteristics.

An excellent wound closure product should not only meet the basic functions of healing and infection prevention, but also should consider the length of operation, medical expenses and the psychological burden of postoperative scars on patients.

Traditional wound closure products, such as suture needles, surgicall staples are basically invasive, and the wound surface is large, which is likely to cause local soft tissue necrosis at the fixed site. It is suitable for the trunk and limbs, but not suitable for high aesthetic requirements, tough local tissues, relatively concealed and narrow wounds, and the traction force cannot be obtained visually and portablely.

The structure design of the zipper wound closure device is relatively simple, which is basically similar to the wound dressing. The main method is to stick the sterilized "zipper" on both sides of the wound, and then the force generated by closing the middle zipper will naturally close the two edges of the incision, and the core The idea is to distribute the force required to stretch the skin over a relatively wide attachment area using selective vector directional forces. The zipper wound closure device can help the wound to heal under normal physiological conditions without causing damage to the skin epidermis. And after healing, it will appear in a linear shape, which is similar to skin striae, and has a better cosmetic effect, and at the same time can achieve the effect of weakening scars.

Different types of closers have different design concepts, and clinical medical staff should choose the appropriate product according to the actual situation. For example, tissue expanders are usually used in scenes that do not require high aesthetics, and the treatment effects of different structures of the retractors are quite different. The skin zipper is suitable for epidermal closure and the closure force and closed wound size are not too large (subcutaneous sutures have been sutured).

To sum up, safety, quickness, simplicity, and beauty are still the goals pursued by surgical closure. In clinical practice, the appropriate closure device should be selected according to the size of the patient's wound injury, the nature of the injury, and the physical condition of the patient.