๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
Partial closure
Partial closure
Partial wound closure may be considered in areas where there is extreme wound tension across the central portion of the defect, such as those on the scalp and lower leg. In such cases, the poles of the wound may be approximated in a linear fashion, but a central area of wound gaping may remain. One option for these repairs is via a Burowโs graft, taken from one of the poles of the wounds (see Chapter 28 for a detailed discussion of skin grafts), though permitting this small area to heal by secondary intention is appropriate as well. Adequate patient preparation is of course a prerequisite to this approach.
Another technique for partial closure is used when extreme tension across a wound does not permit direct side-to-side wound apposition at all.63 While traditionally other repairs would be entertained, in select patients, partial linear closure allowing the remainder of the wound to heal by secondary intention may be appropriate This can be conceptualized as a strategy to reduce the size of the defect that will heal by secondary intention. Such repairs may also be performed prior to skin graft placement.
At times, portions of an otherwise linear repair may be purposely left to heal by secondary intention. For example, when recreating the alar groove, the deepest part of the groove may be left to heal secondarily (or grafted) as an alternative to inverting
suture placement.