A skin stretch system for the immediately closing of the large skin defects of the anterior chest wall following large keloid excision

Large anterior chest wall skin defects following keloid resection, which are not suitable for primary closure, represent a substantial reconstructive challenge, partly due to the expected high tension closure and the considerable rate of recurrence. The TopClosure® Tension Relief System (TRS) is a novel skin stretching and wound closure-secure system which has been shown as a substitute for skin grafts, tissue expanders, and flaps. A 36-year-old man presented with a large keloid with ulcerations on the anterior chest wall. The patient underwent surgical resection of the keloid with immediate primary closure of the chest wall skin defect using the TRS. The surgical procedure and the postoperative period were uncomplicated. The wound was completely closed with a slightly raised scar after the 15th month follow-up. This is a rare case of immediate primary closure of a skin defect following resection of a large keloid of the anterior chest wall by the application of a skin stretching technique named as TRS. The TopClosure® TRS can help simplify the surgical procedures and shorten the operative time. Furthermore, the appliance can also be used for cosmetic improvements of the scar and minimize the need for future reconstructive procedures as well. Level of Evidence: Level V, therapeutic study © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.