TopClosure Tension Relief System for wound closure

The technology described in this briefing is the TopClosure Tension Relief System (TRS). It is used to stretch skin to improve wound closure after injury or surgical procedures.

The innovative aspects are that it can be used for 2 skin stretching techniques; stress–relaxation and mechanical creep. This system also allows stitches to be placed over high-tension wounds without causing ischaemia, necrosis and wound failure which can sometimes arise.

The intended place in therapy would be in the closure of wounds as an alternative to skin grafts, skin flaps or internal tissue expanders in people with large wounds, such as those from trauma, amputation or tumour excision.

The main points from the evidence summarised in this briefing are from 5 studies. These comprised 1 study including a case series and case reports, 1 case series, 2 individual case reports and 1 technical study, with a total of 41 patients altogether. The findings suggest that the TopClosure TRS may help secure wound closure with minimal scarring.

Uncertainties are that the evidence base is not comparative and is very limited in size.

The cost of the TopClosure TRS is £56.40 to £72.50 (exclusive of VAT) for a single set (currency conversion on 22 November 2016). If TopClosure TRS were shown to help faster wound closure and healing compared with standard care, then it could have a resource impact for the NHS in reducing the cost of treating medium and large wounds.