Pushing the envelope: Single stage primary closure of large flap donor sites with continuous external tissue expansion

Helical rim defects are noticeable and may well need reconstruction, especially in men. A method for reconstructing this type of defect together with primary donor site closure by Z-plasty is described.To close partial helical rim defects, a retroauricular caudally based rotational skin flap is performed to cover a conchal cartilage graft from the same ear that is harvested first and sutured into place to remodel the helical rim. To primarily close the donor site defect a retroauricular Z-plasty was developed which easily allowed primary closure of the donor site.The technique described here is straightforward, safe and reproducible. The Z-plasty approach for closing the donor site is useful, since the slight disturbance of the hairline is well hidden retroauricularly. This technique can be considered as a single-stage repair modality for the reconstruction of helical rim defects within primary donor site closure.

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Utilization of a Continuous External Tissue Expansion System to Assist in Primary Closure of a Large Anterolateral Thigh Donor Site Defect

Case Reports in Surgery ◽

10.1155/2014/860749 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3

Author(s):

Andrew G. Silver ◽

Richard C. Baynosa

Keyword(s):

Primary Closure ◽

Donor Site ◽

Tissue Expansion ◽

Skin Grafting ◽

Flap Coverage ◽

Anterolateral Thigh ◽

Expansion System ◽

Donor Site Defect ◽

Alt Flap

Primary closure of a large anterolateral thigh (ALT) flap donor site defect with the assistance of an external tissue expansion system is presented. The dimensions of this donor site (12 cm × 40 cm) and its percentage of leg circumference (34%) would make this site likely to require skin grafting or further flap coverage based on the results of previously published literature.

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Single-Stage Immediate Breast Reconstruction Using a Skin-Sparing Incision and Definitive Saline Implants Compared with a Two-Stage Reconstruction Using Tissue Expansion Plus Implants

Canadian Journal of Plastic Surgery ◽

10.1177/229255030901700416 ◽

2009 ◽

Vol 17 (4) ◽

pp. 117-123 ◽

Cited By ~ 2

Author(s):

Mathew A Plant ◽

Christopher G Scilley ◽

Mark Speechley

Keyword(s):

Breast Reconstruction ◽

Tissue Expansion ◽

Immediate Breast Reconstruction ◽

Single Stage ◽

Two Stage

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Tissue Expansion Using Hyaluronic Acid Filler for Single-Stage Ear Reconstruction: A Novel Concept for Difficult Areas

Aesthetic Surgery Journal ◽

10.1093/asj/sjx119 ◽

2017 ◽

Vol 37 (10) ◽

pp. 1085-1097 ◽

Cited By ~ 2

Author(s):

Amir Inbal ◽

Benjamin T Lemelman ◽

Eran Millet ◽

Andrew Greensmith

Keyword(s):

Hyaluronic Acid ◽

Tissue Expansion ◽

Single Stage ◽

Ear Reconstruction ◽

Novel Concept

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Single-stage immediate breast reconstruction using a skin-sparing incision and definitive saline implants compared with a two-stage reconstruction using tissue expansion plus implant

Plastic Surgery ◽

10.4172/plastic-surgery.1000613 ◽

2009 ◽

Vol 17 (4) ◽

Author(s):

MA Plant ◽

C G Scilley ◽

M Speechley

Keyword(s):

Breast Reconstruction ◽

Tissue Expansion ◽

Immediate Breast Reconstruction ◽

Single Stage ◽

Two Stage

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Wound Closure

Operative Plastic Surgery ◽

10.1093/med/9780190499075.003.0003 ◽

2019 ◽

pp. 21-32 ◽

Cited By ~ 1

Author(s):

David A. Daar ◽

Maristella S. Evangelista

Keyword(s):

Nutritional Status ◽

Medical History ◽

Negative Pressure ◽

Primary Closure ◽

Wound Closure ◽

Tissue Expansion ◽

Therapeutic Interventions ◽

Wound Therapy ◽

Wound Assessment ◽

Patient Optimization

In order to successfully allow for healing, proper wound assessment and planning are of paramount importance. Proper wound closure relies on the optimization of patient and wound characteristics. Factors such as a patient’s age, nutritional status, medical history, medications, and current or previous therapeutic interventions all require consideration. In addition, wound characteristics such as size, shape, contamination, drainage, and odor must also be considered. This chapter will review important principles in wound assessment, patient optimization, and techniques for primary closure. Adjuncts of tissue expansion, dermal substitutes, and negative pressure wound therapy will also be covered briefly.

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Tissue Expander Use for Reconstruction of Scalp Soft Tissue Sarcoma Wide Resection Defects

Plastic Surgery Case Studies ◽

10.1177/2513826x20903503 ◽

2020 ◽

Vol 6 ◽

pp. 2513826X2090350

Author(s):

Matthew A. Strode ◽

Robert F. Lohman ◽

Kilian E. Salerno ◽

John M. Kane

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Primary Closure ◽

Soft Tissues ◽

Tissue Expander ◽

Soft Tissue Sarcomas ◽

Tissue Expansion ◽

Curative Treatment ◽

Wide Resection ◽

Preoperative Radiation

The potentially curative treatment for soft tissue sarcomas is wide resection. When located on the scalp, this can require removal of significant volumes of adjacent soft tissues as well as the skull periosteum. Consequently, reconstruction of the surgical defect is challenging. For patients receiving preoperative radiation or chemotherapy, gradual tissue expansion through the placement of a preoperative tissue expander can allow for primary closure of the wide resection defect, typically with hair-bearing scalp.

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The Tissue-Based Triad in Augmentation Mastopexy: Single-Stage Technical Refinements

Aesthetic Surgery Journal ◽

10.1093/asj/sjz006 ◽

2019 ◽

Vol 39 (12) ◽

pp. 1331-1341 ◽

Cited By ~ 2

Author(s):

Kyle Sanniec ◽

William P Adams

Keyword(s):

Wound Care ◽

Tissue Expansion ◽

Single Stage ◽

Level Of Evidence ◽

Patient Demographics ◽

Number Of Patients ◽

Patient Database ◽

Average Patient ◽

Implant Size ◽

Augmentation Mastopexy

Abstract Background The number of patients seeking augmentation mastopexy has increased over the last several decades. The conflicting goals of augmentation (tissue expansion) and mastopexy (tissue reduction) have led to higher revision rates, decreased patient satisfaction, and pending litigation. Some have even argued for staging of all augmentation mastopexy procedures. Objectives The goal of this study was to review the senior author’s (W.P.A.) process-oriented approach to single-stage augmentation mastopexy and to detail the technical framework to produce reliable, reproducible, safe results in a 1-stage augmentation mastopexy. Methods A prospectively collected patient database from January 2007 until January 2018 was reviewed. All single-stage augmentation mastopexy patients were evaluated, including patient demographics, operative details, complications, and outcomes. Results A total of 251 patients were evaluated. Mean follow-up was 16.9 months, average patient age was 38.0 years, and average implant size was 285.8 cc. A total of 9 (3.6%) patients required reoperation and only 2 (0.8%) required explantation. Fourteen (5.6%) patients developed delayed wound healing that responded to local wound care alone. Conclusions Utilization of a safe and reliable processed approach to single-stage augmentation mastopexy is highly predictable with low reoperation rates. The technical refinements presented have led to increased consistency in delivering high-quality results to patients in a procedure fraught with challenges. Level of Evidence: 4

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