BACKGROUND. The methods described to achieve intraoperative tissue expansio
n have drawbacks.
OBJECTIVE. To report an intraoperative tissue expansion technique using sta
ndard suture material and hemostats to create a "modified" winch stitch.
METHODS. A continuous running suture is placed with both ends left free. A
"fixed" hemostat is placed above the skin at one end. After pulling at the
other end with a second hemostat, a third hemostat is placed proximal to th
is hemostat just above the skin, which is left in place to produce stretchi
ng. The second and third hemostats are then used in an alternating pulling
and holding fashion.
RESULTS. This method produces significant tissue expansion. If the desired
degree of approximation is achieved, the ends of the suture can be tied tog
ether, as in the previously described winch stitch.
CONCLUSION. The modified winch stitch is a simple and inexpensive means to
facilitate closure of wounds under a significant amount of tension.