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.

The Use of Soft Tissue Expanders Prior to Total Ankle Arthroplasty

2017 ◽  
Vol 10 (5) ◽  
pp. 473-479
Author(s):  
Ameya V. Save ◽  
Daniel H. Wiznia ◽  
Mike Wang ◽  
Chang-Yeon Kim ◽  
John S. Reach
Keyword(s):  
Soft Tissue ◽  
Tissue Expander ◽  
Total Ankle Arthroplasty ◽  
Soft Tissue Coverage ◽  
Ankle Arthroplasty ◽  
Tissue Expanders ◽  
Tension Free ◽  
Levels Of Evidence ◽  
Evidence Level ◽  
Free Closure

Soft tissue coverage and tension-free closure can often be challenging in patients with ankle arthropathy being considered for total ankle arthroplasty. We present 2 patients with severe posttraumatic ankle arthropathy who underwent placement of a soft tissue expander to assist with soft tissue coverage prior to total ankle arthroplasty. Levels of Evidence: Level IV

scholarly journals Ten technical considerations revisited in tissue expansion

2020 ◽  
Vol 2020 (8) ◽  
Author(s):  
Luke Geoghegan ◽  
Dariush Nikkhah
Keyword(s):  
Soft Tissue ◽  
Skin Flap ◽  
Tissue Expansion ◽  
Soft Tissue Defect ◽  
Illustrative Case ◽  
Soft Tissue Defects ◽  
Case Presentation ◽  
Versatile Tool ◽  
Technical Factors ◽  
Tissue Defects

Abstract Tissue expansion is a versatile tool in resurfacing soft tissue defects of the breast, extremity, head and neck that involves the placement of a temporary implant adjacent to a soft tissue defect. Incremental expansion exploits the viscoelastic properties of skin to generate a skin flap that can be used to resurface defects and provide cover over permanent protheses. Infection, implant extrusion and skin necrosis are recognized complications of tissue expansion. This article presents a revised framework of 10 technical factors to reduce the risk of complications and optimize outcomes with tissue expansion using an illustrative case presentation.

scholarly journals Palatal Mucoperiosteal Expansion as an Adjunct to Palatal Fistula Repair: Case Report and Review of the Literature

1996 ◽  
Vol 33 (3) ◽  
pp. 255-257 ◽  
Author(s):  
Philip A. Van Damme ◽  
Hans Peter M. Freihofer
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Cleft Palate ◽  
Tissue Expander ◽  
Tissue Expansion ◽  
Review Of The Literature ◽  
Fistula Closure ◽  
Fistula Repair ◽  
Palatal Fistula ◽  
Oronasal Fistula

Case report of conventional palatal soft-tissue expansion in an attempt at cleft palate fistula closure with a standard tissue expander. This technique may be an alternative to a tongue flap to promote closure of persistent oronasal fistula.

Tension-free closure with capsular lengthening in mini posterior total hip replacement

2018 ◽  
Vol 28 (2_suppl) ◽  
pp. 3-9
Author(s):  
Nicola Santori
Keyword(s):  
Soft Tissue ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Tissue Repair ◽  
Posterior Approach ◽  
Dislocation Rate ◽  
Soft Tissue Repair ◽  
Tension Free ◽  
Total Hip ◽  
Free Closure

Purpose: Choice of the best mini invasive surgical approach for total hip replacement remains a controversial topic. The posterior approach is traditionally associated with a higher dislocation rate and the obligation of postoperative restrictions. Soft tissue repair reduces the risk of dislocation yet, posterior closure it is often challenging because of capsular and external rotator contractures. In this article, an original procedure of capsular lengthening and tension-free closure is described and the results of a retrospective single surgeon series of minimally invasive posterior total hip replacement (THR) with capsular repair are presented. Methods: A total of 925 mini posterior total hip replacements performed between 2009 and 2015 were retrospectively reviewed. 2 original types of capsulorrhaphy to decrease tension of the repaired tissues were employed. Absence of posterior envelope stretch during flexion and internal rotation was confirmed intraoperatively with a dynamic test. No postoperative restrictions were used. Results: Capsular lengthening with 1 of the described techniques was required in over 50% of cases for a tension-free closure. 3 patients dislocated in the 867 reviewed procedures (0.35%), 1 requiring revision for instability (0.11%). Conclusions: This soft tissue repair technique after mini posterior approach THR is technically easy, provides a tension-free closure and a low dislocation rate.

scholarly journals Two-Stage Cranioplasty: Tissue Expansion Directly over the Craniectomy Defect Prior to Cranioplasty

2016 ◽  
Vol 9 (4) ◽  
pp. 355-360 ◽  
Author(s):  
EllianneJacira dos Santos Rubio ◽  
Eelke M. Bos ◽  
Ruben Dammers ◽  
Maarten J. Koudstaal ◽  
Anton G. Dumans
Keyword(s):  
Decompressive Craniectomy ◽  
Behavioral Problems ◽  
Skin Flap ◽  
Tissue Expander ◽  
Tissue Expansion ◽  
Skull Defect ◽  
Simple Method ◽  
Bone Damage ◽  
Custom Made ◽  
Titanium Cranioplasty

Performing a skull reconstruction for a long-term existing large cranium defect usually needs either skin enhancement or skin flaps and cranioplasty. This procedure can be accompanied with aesthetic and functional complications. The presented case describes a 27-year-old man in need of a cranial reconstruction following decompressive craniectomy as treatment for severe traumatic brain injury. Autologous cranioplasty after decompressive craniectomy failed due to bone flap infection. Because of cognitive behavioral problems, a protective helmet needed to be worn in awaiting cranioplasty. The final titanium cranioplasty was placed subsequent to scalp expansion. The expansion was realized by placing a temporary and custom-made polymethylmethacrylate (PMMA) plate over the defect with a tissue expander on top of it, using the existing scar and skull defect. Our reported technique avoids additional skin flap creation and accompanied complications such as additional scalp and bone damage. In cognitive damaged patients who need to wear a helmet constantly, this simple method provides, concurrently, protection of the brain and tissue expansion. We demonstrate a successful novel technical manner to provide scalp enhancement by positioning a temporary PMMA graft over the skull defect and placing the tissue expander on top of it.

scholarly journals Reconstruction of congenital microtia after ear canaloplasty using V-Y advancement of a temporal triangular flap

2021 ◽  
Vol 48 (6) ◽  
pp. 614-621
Author(s):  
Hae Yeon Park ◽  
Kyeong-Tae Lee ◽  
Eun-Ji Kim ◽  
Kap Sung Oh
Keyword(s):  
Soft Tissue ◽  
Costal Cartilage ◽  
Tissue Expander ◽  
Tissue Expansion ◽  
Median Number ◽  
Auricular Reconstruction ◽  
Second Stage ◽  
Triangular Flap ◽  
History Of ◽  
Bilateral Lesions

Background Reconstruction of congenital microtia remains challenging, particularly in patients with a history of ear canaloplasty due to insufficient regional soft tissue. The insertion of a tissue expander prior to implantation of the cartilage framework has traditionally been employed. However, this procedure could induce additional morbidity. Herein, we present a method using V-Y advancement of a temporal triangular flap to gain additional soft tissue in these challenging cases.Methods Congenital microtia patients with a history of ear canaloplasty who underwent auricular reconstruction using the Nagata technique between 2016 and 2020 were reviewed. To obtain additional soft tissue, V-Y advancement of a temporal triangular flap was performed concurrently with implantation of the costal cartilage framework, without prior insertion of a tissue expander. The outcomes of these patients with respect to postoperative complications and esthetics were evaluated.Results Eight patients with bilateral lesions were included. No specific complications developed after the first-stage surgery. However, one patient experienced complications after the second stage (auricular elevation). An analysis of the esthetic results showed most patients had excellent outcomes, achieving a satisfactory convolution. The median number of operations needed to complete reconstruction was 2, which was fewer than required using the conventional method with prior insertion of a tissue expander.Conclusions In patients with a history of previous canaloplasty, V-Y advancement of a temporal triangular flap could serve as an alternative to tissue expansion for microtia reconstruction. This technique provided reliable and satisfactory results with a reduced number of surgical stages.

scholarly journals Tissue Expansion Improves the Outcome and Predictability for Alveolar Bone Augmentation: Prospective, Multicenter, Randomized Controlled Trial

2020 ◽  
Vol 9 (4) ◽  
pp. 1143
Author(s):  
Soo-Hwan Byun ◽  
Sun-Hyun Kim ◽  
Sura Cho ◽  
Ho Lee ◽  
Ho-Kyung Lim ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Bone Graft ◽  
Alveolar Bone ◽  
Tissue Expander ◽  
Tissue Expansion ◽  
Control Group ◽  
Bone Augmentation ◽  
Hard Tissue ◽  
Multicenter Randomized Controlled Trial ◽  
Bone Gain

Objectives: The purpose of this study was to evaluate the effectiveness of the intraoral use of subperiosteally placed self-inflating tissue expanders for subsequent bone augmentation and implant integrity. Material and methods: A prospective, multicenter, randomized controlled trial was performed on patients requiring alveolar bone graft for dental implant insertion. Patients were assigned to three groups: tissue expansion and tunneling graft (TET group), tissue expansion and conventional bone graft (TEG), and control group without tissue expansion. Dimensional changes of soft tissue and radiographic vertical bone gain, retention, and peri-implant marginal bone changes were evaluated and secondary outcomes; clinical complications and thickness changes of expanded overlying tissue were assessed. Results: Among 75 patients screened, a total of 57 patients were included in the final analysis. Most patients showed uneventful soft tissue expansion without any inflammatory sign or symptoms. Ultrasonographic measurements of overlying gingiva revealed no thinning after tissue expansion (p > 0.05). Mean soft vertical and horizontal tissue measurements at the end of its expansion were 5.62 and 6.03 mm, respectively. Significantly higher vertical bone gain was shown in the TEG (5.71 ± 1.99 mm) compared with that in the control patients (4.32 ± 0.97 mm; p < 0.05). Hard tissue retention— measured by bone resorption after 6 months—showed that control group showed higher amount of vertical (2.06 ± 1.00 mm) and horizontal bone resorption (1.69 ± 0.81 mm) compared to that of the TEG group (p < 0.05). Conclusion: The self-inflating tissue expander effectively augmented soft tissue volume and both conventional bone graft and tunneling techniques confirmed their effectiveness in bone augmentation. With greater amount of bone gain and better 6 month hard tissue integrity, the TEG group compared to the control group—without tissue expansion—showed that the combined modality of tissue expander use and guided bone regeneration (GBR) technique may improve the outcome and predictability of hard tissue augmentation.

External Tissue Expander for Closing Large Defects of the Extremities and Trunk

2013 ◽  
Vol 17 (6) ◽  
pp. 423-425 ◽  
Author(s):  
Julia Kirschke ◽  
Dimitrios Georgas ◽  
Michael Sand ◽  
Falk G. Bechara
Keyword(s):  
Outpatient Treatment ◽  
Tissue Expander ◽  
Tissue Expansion ◽  
Skin Flaps ◽  
Soft Tissue Defects ◽  
Major Drawback ◽  
Direct Closure ◽  
Atraumatic Needle ◽  
Free Closure ◽  
Tissue Defects

Background: Direct closure is the reconstruction of choice for surface soft tissue defects; however, it may not be suitable for larger defects due to extensive tension. A variety of techniques are available for achieving tension free closure, including skin grafts, skin flaps, and internal or external tissue expansion. Materials and Methods: The external skin expander developed by Blomqvist and Steenfos consists of single tissue expander units that contain an atraumatic needle and two friction stoppers connected via a silicone string. Each device of the expander is inserted under local anaesthesia on each side of the defect at a distance of about 2 cm from each other. Postoperative the silicone strings have to be tightened at least once a day. After about 5 to 10 days a sufficient expansion is achieved and the defect can be closed directly after expander removal. Results: The external tissue expander developed by Blomqvist and Steenfos is an efficient, time-effective, easy-to-handle device that can be inserted under local anesthesia, providing a good functional and satisfactory cosmetic outcome. Due to the comparatively low complication rate, even outpatient treatment is possible. The major drawback of this technique is the possibility of developing uncommon secondary scars under the plastic stoppers.

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

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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