{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T00:16:22Z","timestamp":1787962582559,"version":"build-2784847793"},"reference-count":29,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"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 Orthopaedics"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Wound complications following foot and ankle surgery remain challenging, with rates of 4% to 36% depending on procedure complexity. Mechanical tension contributes to dehiscence through mechanotransduction pathways. The force-modulating tissue bridge (FMTB) reduces tissue-interface pressure from approximately 4000\u2009mm Hg (sutures) to 20\u2009mm Hg. Randomized controlled trial evidence in breast surgery demonstrates 89% relative risk reduction in wound complications; however, data specific to foot and ankle surgery are lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Retrospective case series of consecutive foot and ankle operations closed with FMTBs by a single fellowship-trained surgeon (March-October 2025). Primary outcome was any wound complication within 90\u2009days. Each event was retrospectively classified using a framework consistent with ISO 14155:2020 to distinguish FMTB application-site reactions from other causes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Twenty-nine patients were included (mean age 57.2\u2009years; 66% male; mean body mass index [BMI] 30.9). Most procedures involved the ankle (62%), with complex reconstructions predominating (mean tourniquet time 104\u2009minutes). The 90-day wound complication rate was 41.4% (12\/29; 95% CI: 25.5%-59.3%), consistent with published rates for complex foot and ankle procedures when all wound events are captured. Major complications occurred in 3 patients (10.3%); all were attributable to severe patient-level confounding factors (pre-existing osteomyelitis, morbid obesity with heavy smoking history, and chlorhexidine allergy) rather than the FMTB device. After applying this classification framework, FMTB application-site skin reactions occurred in 2 patients (6.9%). Notable among those without complications was 1 patient with BMI 48.5 and only 1 remaining lower limb.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This case series describes the feasibility and acceptable tolerance of FMTB closure in a consecutive cohort of foot and ankle procedures spanning the full clinical spectrum. The 90-day wound complication rate (41.4%, 95% CI 25.5%-59.3%) is consistent with published rates for high-complexity foot and ankle surgery when all wound events are captured; device-application-site skin reactions occurred in 6.9% of patients (2\/29) and resolved with local wound care. These descriptive data do not establish comparative efficacy. Prospective controlled studies are needed to determine whether FMTB-mediated tension offloading provides incremental wound-healing benefit over conventional closure in this anatomically challenging region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level IV, therapeutic, retrospective case series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/24730114261471165","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T09:47:41Z","timestamp":1787737661000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Experience with Force-Modulating Tissue Bridges (FMTB, Brijjit) for Skin Closure in Foot and Ankle Surgery: A Single-Surgeon Case Series"],"prefix":"10.1177","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0375-6105","authenticated-orcid":false,"given":"Nicholas","family":"Stamatos","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Department of Orthopaedic Surgery, University of California, Davis, Sacramento, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Giza","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Department of Orthopaedic Surgery, University of California, Davis, Sacramento, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Ernst","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Department of Orthopaedic Surgery, University of California, Davis, Sacramento, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9566-6053","authenticated-orcid":false,"given":"Christopher D.","family":"Kreulen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Department of Orthopaedic Surgery, University of California, Davis, Sacramento, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.I.00080"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.K.01088"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.H.00653"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100715606477"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2020.04.015"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2010.0301"},{"issue":"5","key":"e_1_3_4_8_2","first-page":"594","article-title":"Charcot foot reconstruction with midfoot osteotomy and internal fixation","volume":"52","author":"Garchar DJ","year":"2013","unstructured":"Garchar DJ, DiDomenico LA, Bates C. Charcot foot reconstruction with midfoot osteotomy and internal fixation. J Foot Ankle Surg. 2013;52(5):594-600.","journal-title":"J Foot Ankle Surg"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcot.2020.03.025"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.L.01302"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.15.01341"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100714565792"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2022.08.006"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/107110079902000805"},{"key":"e_1_3_4_15_2","first-page":"1178248","article-title":"Mechanical strain drives myeloid cell polarization and fibrotic scar formation","volume":"10","author":"Chen K","year":"2023","unstructured":"Chen K, Henn D, Januszyk M, et al. Mechanical strain drives myeloid cell polarization and fibrotic scar formation. 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