An Ottawa Valley-designed method of quickly closing massive wounds is helping to save limbs in the war in Iraq, according to a study published last month in The American Surgeon.
U.S. military surgeons in Baghdad have been testing a system called dynamic wound closure, which uses elastic strands to apply constant tension to the wound, drawing the edges of the skin together.
The concept is at once simple and innovative, said Alden Rattew, executive vice-president of Canica Design, the Almonte-based surgical tool company and brainchild of Lee Valley Tool chairman Leonard Lee.
“We specialize in putting dynamic forces on soft tissues–muscle and skin–to get it to to where it didn’t used to go before,” Mr. Rattew said.
In Iraq, dynamic wound closure has been particularly effective in treating lower-body injuries inflicted by improvised explosive devices, the study said.
Those injuries often require fasciotomies, huge incisions to relieve pressure and fluid buildup in muscles which can cut off blood supply and lead to amputations.
While saving limbs, fasciotomy wounds are often too large to be stitched or stapled, and can only be closed by radical skin grafts, a painful procedure that results in extensive scarring. Between December 2006 and February 2007, 11 American soldiers were treated for leg fasciotomies using Canica’s device. Ten of the soldiers’ wounds closed within an average of 2.6 days, compared to the weeks and months it can take to recover from skin-graft surgery.
One soldier, however, had to have above-knee amputations after the onset of a blood platelet condition.
The doctors concluded the use of the device to treat wartime injuries is “extremely successful and expedient.”
While Canica is confident its device will become the new standard of care, most hospitals are still relying on skin grafts.
The Ottawa Hospital, however, has been using variations of dynamic wound closure for about five years, said Michael Bell, a plastic surgeon at The Ottawa Hospital and Canica researcher. “It’s reliable and safe and inexpensive, and sure reduces the pain and suffering and morbidity of the patients. It’s got many, many advantages over what was ever done before,” Dr. Bell said.
The device can save a hospital $6,000 to $8,000 per patient, he added.
Doctors are also treating other conditions using Canica’s tissue-stretching technology, including cleft lips and abdominal wall wounds.
After driving over an improvised explosive device in Iraq, a U.S. civilian worker was treated in Germany before being sent home, Mr. Rattew said.
By the time he got back to Michigan, however, he had eviscerated and his abdominal contents were coming out of the wound in his belly. Doctors used Canica’s abdominal wall closure device to realign his muscles.
The condition is often treated with a mesh tissue replacement, which impairs muscle function and can amount to a disability, Mr. Rattew said.
“This gentleman is now bench-pressing 300 pounds and he’s gone back over to Iraq to work again.”
…this post forwarded by Windsor Humanist, Alexander Neil, after a May 14, 2008 article by Tim Shufelt in The Ottawa Citizen