Choosing the right rectangular expander and maximising the benefits from expanded tissue

Durğun, Mustafa; Akşam, Ersin

doi:10.12968/jowc.2019.28.6.416

Cited by 3 publications

(3 citation statements)

References 21 publications

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“…The most important basis for any scar repair is tension-free closure 19 . Durgun and Aksam 20 stated in their retrospective study of 19 patients that height of the expanded tissue should be at least half of the wound length to allow for better wound coverage and repair. Hafezi et al 21 concluded, in a study of 48 cases with a total of 86 tissue expanders placed for treatment of head and neck burn scars, that overexpansion to more than 2 to 4 times the manufacturer's stated maximum volume provides better coverage of the defect with lower complication rates.…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Anterior Capsulotomy and Basal Capsulectomy Adherent to Expanded Scalp Flap During Alopecia Reconstruction in Pediatric Burned Patients

2023

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Background: Scalp expansion is an optimal treatment for alopecia resulting from burn injuries, especially in the pediatric population through providing highly vascularized adjacent local tissues with optimal hair density, color matching, texture, and hair-bearing characteristics. The aim of this study was to evaluate the efficacy of anterior capsulotomy and basal capsulectomy adherent to expanded scalp flap during alopecia reconstruction with scalp expansion in pediatric burned patients. Methods: The study was conducted on 127 patients with an age range of 5 to 19 years who presented with postburn alopecia accompanied by hairline loss. The patients were divided into 2 groups: group I consisted of 58 patients who were operated on using conventional technique, and group II consisted of 69 patients who were operated using modified technique including basal capsulectomy on the skull side and anterior capsulotomy on the expanded scalp flap. Results: The Hairdex, a validated questionnaire of Hair-Specific Health-Related Quality of Life measures, showed that percentage of satisfaction concerning outcomes was 91.50%, psychological well-being was 95%, and self-confidence was 84.30% in group II, compared with 63%, 55.70%, and 66.20%, respectively, in group I. This significant values had a great positive effect on patient satisfaction, changing child's behavior and self-confidence. Conclusion: Although physiological background of tissue expansion is the same, proper flap design with anterior capsulotomy on flap undersurface and basal capsulectomy on the skull side improve results of the traditional method significantly and minimize the complication rate. These surgical modifications provide maximum benefits from expanded tissue, with restoration of the hairline and a uniform hair direction.

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Section: Discussionmentioning

confidence: 99%

The Efficacy of Anterior Capsulotomy and Basal Capsulectomy Adherent to Expanded Scalp Flap During Alopecia Reconstruction in Pediatric Burned Patients

2023

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“…8 Management of CMN can vary from observation to partial or completed surgical excision, with patient and caregiver preferences heavily influencing the approach taken. 9 The approach presented in this article enables surgeons to test different expander sizes and shapes, 10 different expander placement configurations, and different flap designs, allowing the surgeon to determine an optimal approach for each patient in advance of the operation. The approach also creates materials for patient and family education and feedback regarding the procedure.…”

Section: Discussionmentioning

confidence: 99%

3D Printing and Surgical Simulation for Management of Large and Giant Congenital Melanocytic Nevi

Solomon,

Sitzman

2023

Plastic and Reconstructive Surgery - Global Open

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Summary: Tissue expansion with subsequent adjacent tissue transfer is often the preferred and sometimes the only option for reconstruction of large and giant congenital melanocytic nevi. Successful reconstruction with maximal efficiency and optimal aesthetic outcome requires careful planning of the tissue transfer, which itself requires careful selection of the tissue expander size and positioning. Unfortunately, there is little opportunity to gain experience in these skills due to the rarity of this condition. In situations where there is a rare condition that requires a complex technical procedure with much interoperative decision-making, surgical experience can be supplemented with the use of surgical simulation. In this article, we report on the use of three-dimensional patient imaging, three-dimensional printing, and surgical simulation for planning the reconstruction of large and giant congenital melanocytic nevi. We describe how this technology allows us to simulate multiple different approaches to expander placement and adjacent tissue transfer. We also describe how these simulations can be used to create cutting guides to guide final incision design and reduce intraoperative decision-making. Finally, we discuss how these models can be used to educate patients and families about the process and outcomes of nevus excision and reconstruction.

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“…A fresh opportunity was created by Radovan's invention [3]. Since then, TE has become an essential component used for the reconstruction of numerous congenital and acquired wounds in both children and adults [4]. There is an injection site where saline can be administered to inflate the expander, and it is made of a flexible and resilient silicone substance [4].…”

Section: Introductionmentioning

confidence: 99%

Post-Burn and Surgical Scar Reconstruction with Tissue Expanders: Review of the Literature and Our Local Experience

Alharbi,

Moshref,

Badr

et al. 2023

Reports

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Tissue expansion (TE) is a rather widely accepted technique in plastic surgery, with variable indications; among numerous other indications, it is commonly used in scar management. In our research, we focused on the significance of TE as an important armamentarium and valid solution for the treatment of large and old post-burn scars, with good cosmetic and functional outcomes. Our study is a retrospective analysis conducted at Dr. Soliman Fakeeh Hospital, Jeddah, during the period from 2020 to 2023. This retrospective analysis included 15 tissue expanders, which were inserted in eight patients with large post-burn scars. Each patient underwent two stages of scar repair using variable-size tissue expanders. Post-operative assessment for scar quality and patient satisfaction was conducted using the POSAS score system in addition to standard documentation. Our study sheds light on the satisfactory and accepted cosmetic and functional outcomes for skin tissue expanders for post-burn scars and deformities.

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Choosing the right rectangular expander and maximising the benefits from expanded tissue

Cited by 3 publications

References 21 publications

The Efficacy of Anterior Capsulotomy and Basal Capsulectomy Adherent to Expanded Scalp Flap During Alopecia Reconstruction in Pediatric Burned Patients

The Efficacy of Anterior Capsulotomy and Basal Capsulectomy Adherent to Expanded Scalp Flap During Alopecia Reconstruction in Pediatric Burned Patients

3D Printing and Surgical Simulation for Management of Large and Giant Congenital Melanocytic Nevi

Post-Burn and Surgical Scar Reconstruction with Tissue Expanders: Review of the Literature and Our Local Experience

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