scholarly journals Skin stretching by a balloon tissue expander: Interplay between contact mechanics and skin growth

2016 ◽  
Vol 9 ◽  
pp. 175-187 ◽  
Author(s):  
Abhishek Srivastava ◽  
Adrián Buganza Tepole ◽  
Chung-Yuen Hui
Keyword(s):  
Contact Mechanics ◽  
Tissue Expander ◽  
Skin Stretching

scholarly journals Simplified management of a giant forehead congenital nevus allows for early reconstruction

2020 ◽  
Vol 13 (7) ◽  
pp. e234164
Author(s):  
Moris Topaz ◽  
Michael Gurevich ◽  
Itamar Ashkenazi
Keyword(s):  
Tissue Expander ◽  
Early Conclusion ◽  
Complete Excision ◽  
Delayed Primary Closure ◽  
Skin Stretching ◽  
Reconstructive Process ◽  
Simple Alternative ◽  
Early Reconstruction ◽  
A Minor ◽  
Relief System

We report simplified surgical management of giant congenital forehead nevus that customarily requires the use of tissue expander for complete excision. Commencing treatment at the age of 3 months, the TopClosure tension relief system (TRS) was applied as an external tissue expander allowing preoperative skin stretching by mechanical creep. This was followed by partial excision of the nevus. Intraoperative stress-relaxation allowed further expansion of the skin. Postoperative wound closure was secured with the aid of the TRS. Repeated, six simple staged excisions of the forehead lesion and a minor skin graft to the eyelid part, allowed for delayed primary closure of the entire lesion by the age of 2. This simple alternative approach, which allows the early start and early conclusion of the reconstructive process, should be considered as the primary option in the treatment of these patients.

Tissue Expander: Histological and Histochemical Study 6 Months After Transplant—Our Experience

2000 ◽  
Vol 10 (4) ◽  
pp. 12 ◽  
Author(s):  
Giordano Stabellini ◽  
Carla Calastrini ◽  
Anna Marcucci ◽  
Monica De Mattei ◽  
Maria I. Luna-Carbonel ◽  
...  
Keyword(s):  
Histochemical Study ◽  
Tissue Expander

Dissecting Contact Mechanics from Quantum Interference in Single-Molecule Junctions of Stilbene Derivatives

Nano Letters ◽  
2012 ◽  
Vol 12 (3) ◽  
pp. 1643-1647 ◽  
Author(s):  
Sriharsha V. Aradhya ◽  
Jeffrey S. Meisner ◽  
Markrete Krikorian ◽  
Seokhoon Ahn ◽  
Radha Parameswaran ◽  
...  
Keyword(s):  
Contact Mechanics ◽  
Single Molecule ◽  
Quantum Interference ◽  
Single Molecule Junctions ◽  
Stilbene Derivatives

Closure of Complex Wounds by a Simple Skin Stretching System Associated With Vacuum Sealing Drainage—Clinical Outcome of 34 Patients

2021 ◽  
pp. 153473462110320
Author(s):  
Yaojun Wu ◽  
Liang Chen ◽  
Xinliang Mao ◽  
Zhengliang Ru ◽  
Liying Yu ◽  
...  
Keyword(s):  
Vacuum Sealing ◽  
Day Range ◽  
Skin Stretching ◽  
Group A ◽  
Group B ◽  
Vacuum Sealing Drainage ◽  
Real Challenge ◽  
Safe Approach ◽  
Large Skin ◽  
Complex Wounds

Management of complex wounds with large skin defects presents a real challenge for orthopedic or reconstructive surgeons. We developed a simple skin stretching system associated with vacuum sealing drainage to examine the efficiency and complication. A total of 34 patients with different types of complex wounds were retrospectively included from January 2015 to March 2021. All patients in the study were underwent the treatment by 2 stages. The method was used to the wounds from 4.71 to 169.65 cm2 with a median defect size of 25.13 cm2. The median time for wound closure was 11.5 days (range: 5-32 days), although the median absolute reduction was 2.08 cm2/day (range: 0.15-25.66 cm2/day). Depending on the site of the wounds, the cause of the wound, and the rate of max-width/max-length ( W/ L), these complex wounds could be separately divided into several groups. There were statistically significant differences in the median value of the above variables ( P < .05 Kruskal–Wallis test). The results showed that different anatomical sites had different viscoelastic properties, the complex wounds caused by trauma were easier to close than caused by diabetic foot and the complex wounds in group A ( W/ L ＞ 0.5) were more difficult to close than in group B ( W/ L ≤ 0.5). No major complications were encountered in this study. In summary, the results of our study showed that the simple skin stretching system associated with vacuum sealing drainage was a safe approach for closure of complex wounds. Nevertheless, more attention should be paid to the viscoelasticity of the wounds to ensure closure and avoid undue complications when applying the method.

scholarly journals Long-term outcomes of two-stage, immediate and delayed breast reconstruction with polyurethane-covered versus textured implants: protocol of a prospective, multicentre randomised controlled trial (TIPI trial)

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e044219
Author(s):  
J X Harmeling ◽  
Kevin Peter Cinca ◽  
Eleni-Rosalina Andrinopoulou ◽  
Eveline M L Corten ◽  
M A Mureau
Keyword(s):  
Randomised Controlled Trial ◽  
Breast Reconstruction ◽  
Controlled Trial ◽  
Capsular Contracture ◽  
Tissue Expander ◽  
Complication Rates ◽  
Two Stage ◽  
Randomised Controlled

IntroductionTwo-stage implant-based breast reconstruction is the most commonly performed postmastectomy reconstructive technique. During the first stage, a tissue expander creates a sufficiently large pocket for the definite breast implant placed in the second stage. Capsular contracture is a common long-term complication associated with implant-based breast reconstruction, causing functional complaints and often requiring reoperation. The exact aetiology is still unknown, but a relationship between the outer surface of the implant and the probability of developing capsular contracture has been suggested. The purpose of this study is to determine whether polyurethane-covered implants result in a different capsular contracture rate than textured implants.Methods and analysisThe Textured Implants versus Polyurethane-covered Implants (TIPI) trial is a multicentre randomised controlled trial with a 1:1 allocation rate and a follow-up of 10 years. A total of 321 breasts of female adults undergoing a two-stage breast reconstruction will be enrolled. The primary outcome is capsular contracture at 10-year follow-up which is graded with the modified Baker classification. It is analysed with survival analysis using a frailty model for clustered interval-censored data, with both an intention-to-treat and per-protocol approach. Secondary outcomes are other complication rates, surgical revision rate, patient satisfaction and quality of life and user-friendliness. Outcomes are measured 2 weeks, 6 months, 1, 2, 3, 5 and 10 years postoperatively. Interim analysis is performed when 1-year, 3-year and 5-year follow-up is completed.Ethics and disseminationThe trial has been reviewed and approved by the Medical Research Ethics Committee of the Erasmus MC, University Medical Centre Rotterdam (MEC-2018-126) and locally by each participating centre. Written informed consent will be obtained from each study participant. The results will be disseminated by publication in peer-reviewed journals.Trial registrationNTR7265.

scholarly journals Repair Exposure of the Postauricular Tissue Expander Using the Modified Brent Method: A 7-Year Experience

2021 ◽  
pp. 014556132110079
Author(s):  
Tongyu Cao ◽  
Qingguo Zhang
Keyword(s):  
Soft Tissue ◽  
Skin Flap ◽  
Tissue Expander ◽  
Tissue Expansion ◽  
Ear Reconstruction ◽  
Lower Pole ◽  
Tension Free ◽  
Subsequent Exposure ◽  
Free Closure ◽  
Complicated Conditions

Objectives: Ear reconstruction is a challenging surgery for the complicated conditions in patients with microtia. The tissue expansion techniques were necessary and relatively safe for patients with insufficient soft tissue. However, complications such as necrosis of expanded flap and exposure of tissue expander limited the popularization of this method. This study described the use of modified Brent method to handle the exposure of the postauricular tissue expander. Methods: From January 2013 to December 2019, 27 ear reconstruction patients with trauma or necrosis on an expanded skin flap and subsequent exposure of tissue expander were treated with modified Brent method, which consisted of 3 stages: removal of the expander, tension-free closure of wound, and framework fabrication; elevation of reconstructed ear; lobule rotation; and minor modification. Results: Fifty-six percent of exposures occurred in the lower pole of the tissue expander. Exposure usually occurred 54.5 days after implantation. The majority of reconstructed ears had a satisfactory appearance and showed relatively stable outcomes. Only one case of cartilage exposure required revision surgery and was repaired by the temporoparietal fascia. Conclusion: With reasonable distribution of expanded flap, prolonged interval, and sutures under tension-free conditions, complications like the occurrence of trauma or necrosis-induced exposure of tissue expander can be repaired efficiently by a staging modified Brent method.

scholarly journals 890. Incidence and Microbiology of Surgical Site Infection (SSI) after Breast Surgery

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S479-S479
Author(s):  
Farah Tanveer ◽  
Dima Youssef ◽  
Mamta Youssef ◽  
Susanna Szpunar ◽  
Michelle Flood
Keyword(s):  
Surgical Site Infection ◽  
Breast Surgery ◽  
Tissue Expander ◽  
Empiric Therapy ◽  
Site Infection ◽  
Gram Positive ◽  
Historical Cohort ◽  
Gram Negative ◽  
Tissue Expanders ◽  
Student’S T

Abstract Background Surgical site infection (SSI) after breast surgery is much more common than expected after a clean surgical procedure. Although breast SSIs are primarily Gram-positive; recent literature shows an increase in Gram-negative infections. We assessed the risk factors and microbiology of SSI following breast surgery at our institution. Methods We conducted a historical cohort study of all (³ 18 y) females who had surgery from 1/1/2014-3/31/2019 and subsequent SSI within 90 days of the procedure. Two controls, matched for surgery type, were selected per case. Data were collected on demographic and clinical characteristics, surgery type, microbiology and antibiotics. Data were analyzed using the χ 2 test, Student’s t-test and multivariable logistic regression with a forward likelihood ratio algorithm. Results After excluding patients with limited data, we reviewed 284 charts: 95 of 132 cases and 189 controls. The 90-day incidence of SSI was 3.5 % (132/3755). Cases were younger than controls: 53.9 ± 12.4 years vs. 58.3± 13.7 years, respectively, p=0.02. Controls had more comorbidities: 1.8 ± 1.3 vs. 1.4 ± 0.7,respectively, p=0.001. Tissue expanders were placed in 65 (70%) cases versus 11 (5.8%) controls (p &lt; 0.0001). After controlling for age, BMI, comorbidities and post-operative antibiotics, only tissue expanders were associated with infection (OR=35.1, p&lt; 0.0001, 95% CI: 16.6, 74.0). Microbiological data were available for 84 cases. Gram-positive organisms accounted for 45 (53.6%) infections and Gram-negative organisms accounted for 39 (46.4%) infections. Over 72% of African Americans (p= 0.014), 76.5% of patients with diabetes (p=0.005) and 57.1 % with tissue expanders (p= 0.02) had Gram-negative infections. The table shows the multivariable predictors of Gram-negative infection. Tissue expander removal was required in 61.5% of patients with Gram-negative infections compared to 39% with Gram-positive infections. Predictors of Gram-negative SSI after breast surgery Conclusion Patients with tissue expanders had a higher incidence of SSI after breast surgery; removal was often required in Gram-negative infections. Diabetes and post-operative antibiotics were significant predictors of Gram-negative infection. Knowledge of local epidemiology is a key factor in deciding empiric therapy for SSI. Disclosures All Authors: No reported disclosures

Sign in / Sign up

Export Citation Format

Share Document