ENHANCING WOUND CLOSURE ON THE LIMBS

The apposition of tissue on the limbs is more likely to be complicated by excessive wound tension when tissue is lost or the limb circumfere nce increases as a result of trauma. Excessive wound tension can resul t in a so-called biological tourniquet and can compromise circulation distal to the limb wound. Proper application of such simple wound mana gement techniques as undermining, stretching of skin, tension sutures, and relaxing incisions can permit early wound closure, perhaps elimin ating the need for or reducing the size of skin flaps or grafts. These techniques are best considered and performed sequentially as set fort h in this article.