Risk factors for tissue expander infection in scar reconstruction: a retrospective cohort study of 2374 consecutive cases

Abstract

Background Tissue expansion is used for scar reconstruction owing to its excellent clinical outcomes; however, the complications that emerge from tissue expansion hinder repair. Infection is considered a major complication of tissue expansion. This study aimed to analyze the perioperative risk factors for expander infection. Methods A large, retrospective, single-institution observational study was carried out over a 10-year period. The study enrolled consecutive patients who had undergone tissue expansion for scar reconstruction. Demographics, etiological data, expander-related characteristics and postoperative infection were assessed. Univariate and multivariate logistic regression analysis were performed to identify risk factors for expander infection. In addition, we conducted a sensitivity analysis for treatment failure caused by infection as an outcome. Results A total of 2374 expanders and 148 cases of expander infection were assessed. Treatment failure caused by infection occurred in 14 expanders. Multivariate logistic regression analysis identified that disease duration of ≤1 year (odds ratio (OR), 2.07; p < 0.001), larger volume of expander (200–400 ml vs <200 ml; OR, 1.74; p = 0.032; >400 ml vs <200 ml; OR, 1.76; p = 0.049), limb location (OR, 2.22; p = 0.023) and hematoma evacuation (OR, 2.17; p = 0.049) were associated with a high likelihood of expander infection. Disease duration of ≤1 year (OR, 3.88; p = 0.015) and hematoma evacuation (OR, 10.35; p = 0.001) were so related to high risk of treatment failure. Conclusions The rate of expander infection in patients undergoing scar reconstruction was 6.2%. Disease duration of <1 year, expander volume of >200 ml, limb location and postoperative hematoma evacuation were independent risk factors for expander infection.

Nasal Reconstruction for Chinese Patients: A Retrospective Study

“…According to other researches, patients may also encounter kinds of problems or complications, such as infection, extrusion, wound dehiscence and ruptures. 36 The prevention of infection could be managed with an algorithm put forward by Dong et al 37 Nevertheless, we did not observe any complications directly related to the transferred ap, like necrosis or infection, except for two cases of leakage during the gradual process of tissue expansion. Radwan et al 38 attributed the occurrence of leakage to 3 reasons: (1) inadvertent puncture of the tubing or the prosthesis; (2) improper securing of the connector; (3) use of an appropriate needle into the injection port.…”

Expanded forehead flap in Asian nasal reconstruction

“…According to other researches, patients may also encounter kinds of problems or complications, such as infection, extrusion, wound dehiscence and ruptures 38 . The prevention of infection could be managed with an algorithm put forward by Dong et al 39 . Nevertheless, we did not observe any complications directly related to the transferred flap, like necrosis or infection, except for two cases of leakage during the gradual process of tissue expansion.…”

Endoscopy-assisted versus open tissue expander placement in plastic and reconstructive surgery: a meta-analysis

“…Our previous study found that a haemotoma offers an ideal medium for bacterial proliferation and greatly increases the possibility of expander infection. 32 Remote incision, far from the stress of the expansion, also minimizes the chances of wound dehiscence. 12 Whether the risks of extrusion and de ation can be reduced by the endoscopic technique remain controversial.…”