{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T06:14:28Z","timestamp":1777616068139,"version":"3.51.4"},"reference-count":20,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2015,8,5]],"date-time":"2015-08-05T00:00:00Z","timestamp":1438732800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot &amp; Ankle Specialist"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:p>Despite major improvements in surgical technique and implant designs in total ankle arthroplasty (TAA), wound healing complications are still commonly encountered. Not only do these problems delay postoperative recovery and threaten functional outcomes, they also carry an increased risk of progression to deep wound infection, which can jeopardize ultimate retention of the implant. In an effort to reduce the high frequency of wound-related complications after TAA, we have incorporated the use of continuous external tissue expansion (CETE) to augment our closures of the anterior ankle incision. CETE is an innovative technique that is currently being used to aid in the rapid closure of acute and chronic full thickness soft tissue defects, including fasciotomy wounds, high grade open fractures, and chronic foot ulcers. By exploiting the viscoelastic properties of the skin, this technique not only facilitates wound edge approximation of full thickness defects, it also helps take tension off tenuous incisions, thus allowing them to heal and reducing the chance for wound dehiscence. This is the first description of the use of an external tissue expander for the prevention of wound healing complications in the setting of TAA. Since introducing CETE to the closure of our TAA incisions, we have seen a decrease in the number of postoperative wound complications and time to wound healing. Based on our experience, we believe that the use of CETE for the prophylactic management of tenuous surgical incisions, specifically those used in the anterior approach to the ankle during TAA, is both safe and efficacious.<\/jats:p>\n                  <jats:p>Levels of Evidence: Level V: Technique tip<\/jats:p>","DOI":"10.1177\/1938640015598839","type":"journal-article","created":{"date-parts":[[2015,8,5]],"date-time":"2015-08-05T21:40:33Z","timestamp":1438810833000},"page":"43-47","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["Use of a Continuous External Tissue Expander in Total Ankle Arthroplasty"],"prefix":"10.1177","volume":"9","author":[{"given":"Jeannie","family":"Huh","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Selene G.","family":"Parekh","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University Medical Center, Durham, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2015,8,5]]},"reference":[{"key":"bibr1-1938640015598839","first-page":"367","volume":"59","author":"Coetzee JC","year":"2010","journal-title":"Instr Course Lect"},{"key":"bibr2-1938640015598839","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.J.00126"},{"key":"bibr3-1938640015598839","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-009-0987-3"},{"key":"bibr4-1938640015598839","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2009.0579"},{"key":"bibr5-1938640015598839","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2009.0945"},{"key":"bibr6-1938640015598839","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.I.00870"},{"key":"bibr7-1938640015598839","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2010.0301"},{"key":"bibr8-1938640015598839","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.K.00593"},{"key":"bibr9-1938640015598839","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199308000-00010"},{"issue":"2","key":"bibr10-1938640015598839","first-page":"3","volume":"1","author":"Nielson D","year":"2008","journal-title":"Foot Ankle Online J"},{"key":"bibr11-1938640015598839","doi-asserted-by":"publisher","DOI":"10.1097\/BTO.0b013e31824885fa"},{"key":"bibr12-1938640015598839","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e31824a4584"},{"key":"bibr13-1938640015598839","unstructured":"DermaClose. Continuous external tissue expander: how it works. 2014.http:\/\/dermaclose.com\/physicians-2\/. Accessed February 1, 2015."},{"key":"bibr14-1938640015598839","unstructured":"DermaClose. DermaClose high tension offloading. 2014. http:\/\/dermaclose.com\/wp-content\/uploads\/2014\/10\/DermaClose-High-Tension-Offloading-Guide-7-DR-0112_A.pdf. Accessed February 1, 2015."},{"key":"bibr15-1938640015598839","doi-asserted-by":"publisher","DOI":"10.1177\/1071100714543643"},{"key":"bibr16-1938640015598839","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2012.1011"},{"key":"bibr17-1938640015598839","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2012.10.007"},{"key":"bibr18-1938640015598839","doi-asserted-by":"publisher","DOI":"10.1177\/1071100714534217"},{"key":"bibr19-1938640015598839","unstructured":"Tauber D, Agag R. Efficacy and cost effectiveness in fasciotomy closure using continuous external tissue expansion. Paper presented at: The 30th Annual Meeting of the Northeastern Society of Plastic Surgeons; September 20-22, 2013; Washington, DC."},{"key":"bibr20-1938640015598839","unstructured":"DermaClose. Continuous external tissue expansion: instructions for use. 2014. http:\/\/dermaclose.com\/wp-content\/uploads\/2014\/10\/DermaClose-Instructions-for-Use-DR-0079_J.pdf. Accessed February 1, 2015."}],"container-title":["Foot &amp; Ankle Specialist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1938640015598839","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1938640015598839","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1938640015598839","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T21:33:05Z","timestamp":1777411985000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1938640015598839"}},"subtitle":["A Novel Augment to Wound Closure"],"short-title":[],"issued":{"date-parts":[[2015,8,5]]},"references-count":20,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2016,2]]}},"alternative-id":["10.1177\/1938640015598839"],"URL":"https:\/\/doi.org\/10.1177\/1938640015598839","relation":{},"ISSN":["1938-6400","1938-7636"],"issn-type":[{"value":"1938-6400","type":"print"},{"value":"1938-7636","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,8,5]]}}}