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A team of battle zone surgeons led by Maj. Niten Singh, M.D. working inthe 28th Combat Support Hospital in Baghdad during Operation Iraqi Freedom,used Canica(R) Inc.'s ABRA(R) Surgical Skin Closure System to successfullyimplement a new surgical regimen called dynamic wound closure (DWC). Describedin a paper published in The American Surgeon, the procedure applies gentle butcontinuing tension uniformly across a wound for a period of a few days togradually but completely close it. Skin grafting is eliminated.
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A surgeon sometimes must make a long incision to perform a fasciotomy --usually on a badly injured arm or leg -- to relieve dangerous swelling andpressure due to fluid buildup. Fasciotomies must often be performed quicklyfollowing trauma and can mean the difference between loss of life or limb, butresult in long, gaping wounds which can be difficult to close. More than16,000 are performed in U.S. hospitals annually.
"Because of the swelling that occurs with the muscles, these wounds cannottypically be closed with sutures," explained Dr. Singh, who is based atMadigan Army Medical Center, Tacoma, Wash. "Traditionally, surgeons have leftthese wounds open and covered them with skin grafts. This results in anadditional wound from harvesting the graft, potential failure of the skingraft and unsightly scars."
"Using Canica's system, we were able to close fasciotomies in an average2.6 days -- several times faster than other techniques," said Dr. Singh."Canica's system is designed for early placement and our findings indicateearly placement is key to success, allowing skin approximation to occurfaster. Overall, we do believe this is a superior technique."
Dynamic Wound Closure: beginnings of a new standard of care
Another recent study supports Dr. Singh's belief that beginning dynamicwound closure as early as possible saves more lives and limbs. The research,published in The Journal of Trauma Injury, Infection, and Critical Careconcluded that performing fasciotomies in battlefield hospitals -- rather thanwaiting to perform them hours or days later at Landstuhl Regional MedicalCenter (LRMC) in Germany -- resulted in 3 times fewer deaths and reduced therate of amputations by half. Using dynamic wound closure, these earlyfasciotomies can now be rapidly and reliably closed, and secondary surgicalprocedures can be avoided.
Faster healing minimizes complications, patients leave the hospital soonerand civilians require less home care. This results in considerable costsavings.
"Dynamic wound closure using our devices can reduce total costs fromsurgeries like these by more than 40%," noted Alden Rattew, Canica's executivevice president. "It has highlighted the fact that increased patient benefitand reduced healthcare costs can be realized simultaneously if wounds can justbe closed quickly."
The really good news is that dynamic wound closure can be used on manytypes of wounds, not just fasciotomies. In addition to closing other extremitywounds, Canica makes dynamic wound closure systems for a wide range of wounds,from skin lacerations to large abdominal eviscerations. Its dynamic technologyis also used in devices that protect wounds from re-opening, and those usedfor babies born with cleft lip -- gradually pulling the cleft lip segmentstogether in preparation for repair surgery.
"Military surgeons are reporting substantial improvements in care by usingCanica's wound closure systems," Rattew said. "As more civilian surgeons learnabout dynamic wound closure and our easy-to-use devices, millions of patientseverywhere will benefit."
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