The Sure Closure indexed skin stretching device was used in four patients with considerable skin defects of varying etiology. The bedside application of the device under local anesthesia and incremental stretching proved to be an effective and easy method. Gradual tightening of the tension meter and simple wound care for 24–48 h resulted in tension-free approximation of wound margins which could then be sutured easily. Three wounds healed primarily with acceptable scars, but in one patient the sutures had to be removed 6 h postoperatively, as this resulted in a gaping wound because of impending compartment syndrome. This case shows that the use of the device intraoperatively is quite safe for smaller defects, but when used in much wider defects in the extremities, it carries the risk of compartment syndrome. The device is good for acute as well as subacute and chronic but clean wounds. It is a good adjunct for wound care with minimal surgery, few complications, and eventual good scarring.