Berman et al. describe a bedside technique for gradually closing fasciotomy wounds using a silastic vessel loop threaded through skin staples — the 'shoelace' — to reapproximate retracted skin edges as compartment edema resolves, avoiding skin grafting or secondary healing.
When you perform a fasciotomy, place the shoelace construct at the index procedure — waiting until closure is attempted is too late, as skin fixes to muscle within days. Daily bedside tightening then allows primary closure in under two weeks without a skin graft.
Berman et al. describe a bedside technique for gradually closing fasciotomy wounds using a silastic vessel loop threaded through skin staples — the 'shoelace' — to reapproximate retracted skin edges as compartment edema resolves, avoiding skin grafting or secondary healing.
When you perform a fasciotomy, place the shoelace construct at the index procedure — waiting until closure is attempted is too late, as skin fixes to muscle within days. Daily bedside tightening then allows primary closure in under two weeks without a skin graft.