A History of Tissue Expansion

Abstract

Tissue expansion is becoming widely used and accepted and its continued use under many circumstances is justified by the experimental and clinical results.

Ilizarov Wound Closure Method for Traumatic Soft Tissue Defects

“…The epidermis responds to a constant tension load with a burst of mitotic activity in the basal cell layer peaking within 24 to 48 hours and normalizing within 6 days. 6 Light microscopy demonstrates a thickened epidermis at the level of the stratum spinosum and flattening of the rete ridges independent of expansion time, volume, location of expansion, or age of the patient. 5,19 Electron microscopy shows decreased intercellular space which is progressive with time.…”

“…6,7,27 The biomechanical properties of skin under tension was first described in 1967. 13 These viscoelastic properties of skin include "creep" (constant load resulting in increases extension over time) and "stress-relaxation" (force required to maintain stretch at a fixed length that is decreased over time).…”

“…13 These viscoelastic properties of skin include "creep" (constant load resulting in increases extension over time) and "stress-relaxation" (force required to maintain stretch at a fixed length that is decreased over time). 6 Tissue creep may be further characterized as mechanical or biological. Mechanical tissue creep refers to the viscoelastic ability of the skin to incrementally lengthen in an acute fashion.…”

“…26 The dermis is substantially affected by expansion. 6 Initial response of the dermis is an overall decrease in thickness, accompanied by changes in the collagen structure throughout the papillary and reticular dermis, as well as dilation of papillary dermal capillaries. 18 A net gain of epidermal hydroxyproline content occurs, suggesting an increase in collagen synthesis.…”

Soft tissue expansion before vertical ridge augmentation: Inflatable silicone balloons or self-filling osmotic tissue expanders?

“…After implantation, the increase of expander volume over time causes tension on the surrounding tissue and results finally in tissue gain. [2930] Presently, these expanders are used for a variety of indications, such as breast reconstruction, defect coverage after excision and preparations of tissue donor sites. [3132] Therefore, these expanders are successfully used for reconstruction of deficient alveolar ridges and thus overcome the numerous disadvantages associated with other surgical procedures.…”