Tissue expansion as an alternative to skin grafting for closure of skin deficits

1992 ◽  
Vol 82 (5) ◽  
pp. 249-259 ◽  
Author(s):  
GR Johnson ◽  
P Han ◽  
JA Giacopelli
Keyword(s):  
Case Report ◽  
Lower Extremity ◽  
Subcutaneous Tissue ◽  
Tissue Expander ◽  
Tissue Expansion ◽  
Skin Grafting ◽  
High Rate ◽  
Expansion Process ◽  
Technical Aspects ◽  
Tissue Expanders

Recent advances in the technical aspects of tissue expanders for closure of skin deficits have led to an overall reduction in the high rate of complications typically associated with their usage. The authors provide a review of the recent refinements in the technique of the tissue expansion process. A discussion of current and future applications using this technique in the treatment of various lower extremity pathologies, including clubfoot, is presented. A case report on the use of a subcutaneous tissue expander for the treatment of a failed skin graft of the medial ankle is included.

scholarly journals Accidental Magnetic Resonance Imaging Activation of Carbon Dioxide Tissue Expanders

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Carissa L Patete ◽  
Michael Plastini ◽  
Prakash J Mathew ◽  
Jason J Yoo ◽  
Zubin Panthaki
Keyword(s):  
Magnetic Resonance Imaging ◽  
Carbon Dioxide ◽  
Case Report ◽  
Magnetic Resonance ◽  
Breast Reconstruction ◽  
Tissue Expander ◽  
Resonance Imaging ◽  
Level Of Evidence ◽  
Tissue Expanders ◽  
Permanent Implants

Abstract Implant-based reconstruction is the most common form of breast reconstruction following mastectomy. It is most often performed in 2 stages using saline-based tissue expanders, which are then exchanged for permanent implants. Serial expansions are performed by accessing a port in the office, an inconvenient and sometimes painful process. A carbon dioxide tissue expander is a device that provides a needle-free, patient-controlled expansion utilizing a remote-controlled CO2 canister. While a patient-controlled expansion offers convenience, given that the CO2 reservoir holds approximately 1500 mL of gas, the potential for malfunction resulting in an uncontrolled expansion in unique to this device. The authors present a case report of a patient with bilateral pre-pectoral tissue expanders who underwent magnetic resonance imaging, resulting in uncontrolled expansion. Level of Evidence: 5

scholarly journals Tissue expander complications in plastic surgery: a 10-year experience

2002 ◽  
Vol 57 (3) ◽  
pp. 93-97 ◽  
Author(s):  
Marcelo Sacramento Cunha ◽  
Hugo Alberto Nakamoto ◽  
Marisa Roma Herson ◽  
José Carlos Faes ◽  
Rolf Gemperli ◽  
...  
Keyword(s):  
Plastic Surgery ◽  
Tissue Expander ◽  
Tissue Expansion ◽  
The Other ◽  
Complication Rates ◽  
Previous Surgery ◽  
Anatomic Site ◽  
Tissue Expanders ◽  
Safe Technique ◽  
Short Time

INTRODUCTION: Tissue expanders have been of great value in plastic surgery. Tissue expansion was developed for a specific indication; however, within a very short time, the concept of tissue expansion found wide applicability. From 1990 to 1999, 315 expanders in 164 patients were utilized. A retrospective analysis of complications and prognostic factors for complications were done. METHODS: The indications for tissue expansion were burns (50%), trauma (32%), and sequelae of previous surgery (8.8%). The expanders were inserted most frequently in the scalp, trunk and neck. RESULTS: There were 22.2% of complications and the most common were expander exposure (50%), infection (24%) and bad function of the expander (12.8%). The present study revealed an increased rate of minor complications in the group of 0 to 10 years of age and an increased rate of major complications for face and neck expansions compared to trunk expansion. There were no increased complication rates for the other age and anatomic site groups, previous expansion, concomitant expansion and type of expander used. CONCLUSIONS: The outcomes from tissue expansion procedures done in our hospital are similar to those reported in the literature. Tissue expansion is a good and safe technique.

Latex allergy in association with tissue expansion

1995 ◽  
Vol 3 (3) ◽  
pp. 1-5
Author(s):  
Ronald M Zuker ◽  
Marius Sapijaszko
Keyword(s):  
Case Report ◽  
Anaphylactic Reaction ◽  
Tissue Expansion ◽  
Latex Allergy ◽  
Tissue Expanders ◽  
Sequence Of Events

This case report outlines the sequence of events in an intraoperative anaphylactic reaction as the pockets for tissue expanders were bing developed. Previous expansion had been carried out uneventfully suggesting previous sensitization. Subsequent testing revealed significant latex allergy. Latex avoidance during repeated tissue expansion is recommended.

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.

scholarly journals Minimising the donor area morbidity of radial forearm phalloplasty using prefabricated thigh flap: A new technique

2017 ◽  
Vol 50 (01) ◽  
pp. 091-095 ◽  
Author(s):  
Aditya Aggarwal ◽  
Hardeep Singh ◽  
Sanjay Mahendru ◽  
Vimalendu Brajesh ◽  
Sukhdeep Singh ◽  
...  
Keyword(s):  
Donor Site ◽  
Tissue Expander ◽  
Tissue Expansion ◽  
Skin Grafting ◽  
Free Flaps ◽  
Standing Position ◽  
Donor Site Morbidity ◽  
New Technique ◽  
Donor Area ◽  
Radial Forearm

ABSTRACTPhalloplasty is indicated in various conditions of penile loss or absence. There are numerous techniques for phalloplasty including the pedicle and free flaps with the ultimate goal of micturition in standing position, attaining adequate size, aesthesis and sensations for sexual intercourse. Radial forearm phalloplasty is the gold standard flap to achieve above results but gives a very bad scar on the forearm. We present a technique of using prefabricated thigh flap to reduce the morbidity of donor area. The descending branch of lateral circumflex femoral pedicle was placed in a subcutaneous plane over tissue expander. After attaining an adequate size of flap with tissue expansion, it was delayed 3 weeks before phalloplasty. Prefabricated flap was thin and of large size replicating the radial forearm flap used for phalloplasty. Whole forearm defect was covered with the thigh flap, and the thigh could be closed primarily. This new technique of using prefabricated thigh flap has significantly reduced the donor site morbidity both aesthetically and functionally without the use of skin grafting in the whole procedure.

scholarly journals Use of Preexpanded Forehead and Neck Skin in Case of Giant Facial Hairy Naevus: Planning and Technique

2020 ◽  
Author(s):  
Mukesh Kumar Sharma ◽  
Naveen Kumar ◽  
V. Suman Babu ◽  
Vinay Kumar Tiwari
Keyword(s):  
Case Report ◽  
Tissue Expansion ◽  
Surgical Excision ◽  
Tissue Expanders ◽  
Pigmented Lesion ◽  
Complete Surgical Excision ◽  
Good Cosmetic ◽  
The Right ◽  
Staged Reconstruction

AbstractA congenital nevi is a pigmented patch which requires complete surgical excision for cosmetic reasons. Here, we report a case of a patient with facial hairy pigmented lesion, occupying the right half of her face since birth, who underwent complete surgical excision and staged reconstruction utilizing, preexpanded forehead and neck skin. We used two rectangular tissue expanders with 150 and 300 cubic cm of volumes inserted in the forehead and the neck, respectively. The length of the expanders selected were equal to 1.2 to 1.5 times the length of their respective lesions, whereas the width of the base of the expanders were approximately similar to the width of their defects. It is concluded with this case report that tissue expansion provides a good cosmetic and anatomical correction to cover large defects, with adjacent skin having similar properties.

Calvarial and Scalp Reconstruction

2019 ◽  
Author(s):  
Matthew M Hanasono
Keyword(s):  
Tissue Expander ◽  
Tissue Expansion ◽  
Skin Grafting ◽  
Free Flaps ◽  
Cranial Bone ◽  
Wound Complications ◽  
Neurosurgical Procedures ◽  
Advantages And Disadvantages ◽  
Scalp Reconstruction

Scalp reconstruction involves nearly the entire spectrum of reconstructive surgery, including skin grafting, local flaps, and microvascular free flaps. Additionally, tissue expansion can play important role in maximizing outcomes. In recent years, reconstructive algorithms specific to scalp reconstruction have been developed that consider not only the size of the defect, but the quality of local tissues.  Many materials have been used for calvarial reconstruction and most modern alloplasts are as reliable as autologous bone, although each as its own advantages and disadvantages.  Simultaneous scalp and calvarial reconstruction is now routinely performed.  Remaining challenges include management of wound complications over alloplasts and of the infected cranial bone flap following neurosurgical procedures. This review contains 15 figures, 5 tables, and 41 references. Keywords: scalp, calvarium, cranioplasty, free flap, tissue expander, skin graft, bone graft, titanium mesh, methylmethacrylate, polyetheretherketone (PEEK)

The Use of Autologous Fat Transplantation to Remedy the Iatrogenic Lipoatrophic Effect of Tissue Expanders

2005 ◽  
Vol 22 (3) ◽  
pp. 187-189 ◽  
Author(s):  
Riad Roomi
Keyword(s):  
Case Report ◽  
Normal Skin ◽  
Tissue Expansion ◽  
Premalignant Lesions ◽  
Treatment Modalities ◽  
Fat Transplantation ◽  
Autologous Fat ◽  
Tissue Expanders ◽  
Autologous Fat Transplantation ◽  
Arm Circumference

Introduction: Tissue expanders have become a popular modality in plastic and cosmetic surgery. Many victims of burns and severe trauma, premalignant lesions, congenital malformations, unwanted or regretted tattoos over large areas, women undergoing postmastectomy breast reconstruction, or men with extensive male-pattern alopecia may seek treatments that use tissue-expansion techniques. Tissue expansion has been an excellent tool for expanding normal skin to provide good quality, cosmetically appealing, full-thickness skin coverage of defective areas. However, like most treatment modalities, tissue expanders have some undesired pitfalls, sequelae, and complications associated with their use. We used autologous fat transplantation to remedy asymmetrical arm circumference after skin expansion on one arm and report our results in this case report. Case Report and Procedure: The patient is a 16-year-old female who presented with a congenital hairy nevus measuring 6.5 × 5.5 cm in the middle part of the posterolateral aspect of her left arm. Treatment included the use of tissue expanders, followed by excision of the nevus to treat the area. After the treatment, the patient complained that her left arm had become thinner than the right. Circumference of both arms measured at symmetrical points revealed a variance of 3 cm. Autologous fat transplant surgery, with a slight overcorrection that was expected to reduce over time, was offered as a solution. Conclusions: Autologous fat transplantation can be used as an adjunct to tissue expansion to fill the lipo-atrophic defects that may result from tissue expansion. Results: Postoperative follow up revealed sound healing of the wound. Her left arm circumference decreased over the following 6 weeks postoperatively (the overcorrection). The final result was symmetrical arms, both visually and numerically.

scholarly journals Reconstruction of Lower Extremity Necrotizing Fasciitis with Tibialis Anterior Musculofascial Flap and Skin Graft: A Case Report

2021 ◽  
Vol 17 (3) ◽  
pp. 222-226
Author(s):  
Jinhyun Kim ◽  
Taewoon Kim ◽  
Seokchan Eun
Keyword(s):  
Case Report ◽  
Lower Extremity ◽  
Necrotizing Fasciitis ◽  
Tibialis Anterior ◽  
Tibialis Anterior Muscle ◽  
Traumatic Injury ◽  
Skin Grafting ◽  
Split Thickness Skin Grafting ◽  
Lower Extremity Reconstruction ◽  
The Right

Necrotizing fasciitis of the lower extremities results in large tissue defects, and most cases require reconstruction using skin grafts or flaps. We describe a 61-year-old man who developed necrotizing fasciitis of the right lower leg and septic shock, following a traumatic injury to his leg. Wound culture yielded methicillin-resistant Staphylococcus aureus. Extensive debridement was performed four times along with the use of appropriate antibiotics. After 2 weeks, physical examination showed an open wound (approximately 30×20 cm in size) with partial tibial bone exposure. Subsequently, the patient underwent successful reconstruction using a tibialis anterior musculofascial flap and split-thickness skin grafting. The tibialis anterior muscle was bihalved and pivoted to cover the exposed bone surface. The patient was without pain and was able to successfully perform daily activities at the 15-month follow-up. This case report highlights the utility of a bihalved tibialis anterior musculofascial flap for lower extremity reconstruction, particularly in patients for whom free flap transfers are unviable.

CT Demonstration of the Extensive Extension of the Emphysematous Gangrene of the Lower Extremity Extending tothe Body: A Case Report

1996 ◽  
Vol 35 (2) ◽  
pp. 241
Author(s):  
Hak Soo Lee ◽  
Hyun Chul Rhim ◽  
Yong Soo Kim ◽  
Soon Young Song ◽  
Byung Hee Koh ◽  
...  
Keyword(s):  
Case Report ◽  
Lower Extremity
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