Clinical Application and Outcome Assessment of a Novel Adhesive-Based Shoelace Wound Closure Device (EZip): A Retrospective Case Series.

Abstract

The reconstruction of large skin and soft tissue defects is challenging, and delayed primary closure can be an alternative method to prevent donor site morbidity and complications. Several dermatotraction techniques have been used to facilitate delayed primary closure, but they mostly use staples or sutures for anchorage. A novel dermatotraction device using adhesive fixation called the adhesive-based shoelace wound closure device (EZip) was launched in Taiwan. This study aims to assess the clinical application of EZip in treating various wounds. From August 2022 to January 2025, data on patients using EZip for wound closures were collected. The applications included gradual wound advancement and postclosure tension release. Patient demographics, wound healing outcomes, and complications were recorded. Pain perception during EZip tightening and removal was measured using a visual analog scale (VAS) ranging from 0 (no pain) to 10 (worst possible pain). Patient satisfaction level was measured using a 5-point Likert scale, with 5 indicating highest satisfaction and 1 indicating lowest. This study included 19 patients. The most common wound etiology was soft tissue infection (n = 12), followed by flap donor site (n = 3), tumor excision (n = 2), traumatic avulsion (n = 1), and compartment syndrome (n = 1). Nine patients underwent wound advancement using EZip, 8 patients underwent postclosure tension release using EZip, and 2 patients underwent both procedures using EZip. Overall, 16 (84.2%) patients achieved wound healing, whereas 3 (15.8%) patients required additional skin graft. The average pain score was 2.64 with EZip tightening. The average pain score was 0.4 after EZip removal. Furthermore, the average overall satisfaction was 4.26. This adhesive-based shoelace wound closure device (EZip) provides a safe and effective way to close various wounds. It is less painful during wound approximation and removal. The tightening procedure could be reversible, and the tension could be adjusted by an individual set of EZip. A comprehensive skin assessment is essential before applying the device in trauma-related wounds.