Scalp Stretching with a Tissue Expander for Closure of Scalp Defects

Nordström, Rolf E. A.; Devine, John

doi:10.1097/00006534-198504000-00025

Cited by 76 publications

(22 citation statements)

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“…When sutured under a significant amount of tension, the skin tends to retract although not eventually back to its original condition before stretching (35). This is the stretch‐back phenomenon which to a considerable extent reduces the benefits of fusiform excision and closure under tension (36). Studies on reduction of male baldness by serial excisions and closure under tension have shown that almost one third to one half of the excised bald area is lost due to the stretch‐back, and that almost all the stretching occurs during the first 8 weeks following surgery (36).…”

Section: Discussionmentioning

confidence: 99%

“…This is the stretch‐back phenomenon which to a considerable extent reduces the benefits of fusiform excision and closure under tension (36). Studies on reduction of male baldness by serial excisions and closure under tension have shown that almost one third to one half of the excised bald area is lost due to the stretch‐back, and that almost all the stretching occurs during the first 8 weeks following surgery (36). Moreover, it was also shown that although undermining significantly diminishes the tension on wound margins, increasing amount of tension while advancing a scalp flap affects the compliance of the flaps in a nonlinear fashion demonstrating an exponential stress–strain characteristic of rapidly increasing stiffness (37).…”

Section: Discussionmentioning

confidence: 99%

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Reverse tissue expansion by liposuction deflation for revision of post-surgical thigh scars

Ibrahim

Dibo

Hayek

et al. 2011

International Wound Journal

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Scars hypertrophy and widen when stretching mechanical forces are applied to resilient newly formed collagen before it reaches final maturity marring the final result of many surgical procedures and resulting in a clinical problem for many patients. Scar revision by surgical excision remains the traditional treatment for hypertrophic or widespread scars. It relies upon recruitment of local tissues for closure of the ensuing defect. Providing tension-free skin closure is the best option to avoid recurrence. Although tissue expansion procedure is a valuable and reliable technique for scar revision, it has its own disadvantages and potential complications. We describe an alternative method for scar revision that may be applicable in certain situations. Instead of expanding the soft tissues to make available additional skin, deflation by liposuction may be affected to relax the skin envelope thus indirectly providing additional skin for scar revision. We call this method 'reverse tissue expansion'.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Reverse tissue expansion by liposuction deflation for revision of post-surgical thigh scars

Ibrahim

Dibo

Hayek

et al. 2011

International Wound Journal

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“…However, the number of follicles does not increase, and relative hair density decreases slightly in expanded scalp secondary to an increased interfollicular distance. The cosmetic impact of this slight density decrease is usually insignificant 18 …”

Section: Indicationsmentioning

confidence: 99%

Chronic Tissue Expansion

Collins

Swanson

1993

The Journal of Dermatologic Surgery and Oncology

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“…The only technique that has been applied successfully in middle-sized scalp defects is through the use of a tissue expander. Nordstrom et al 7 applied a tissue expander for the reconstruction of scalp defects with excellent results, and many authors have subsequently reported similar benefits. 8–12 …”

mentioning

confidence: 97%

A Retrospective Analysis on the Proper Size of Tissue Expanders to Treat Scalp Lesions

Aya

Kawai

Kawazoe³

et al. 2014

Plastic and Reconstructive Surgery Global Open

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Background:Tissue expanders have become established instruments for scalp reconstruction. However, selection of the size of the expander has not been investigated systematically, and it generally depends on the experience of the surgeon.Methods:We retrospectively analyzed 21 patients who had undergone treatment for scalp lesions using tissue expanders without any complications and measured 2 variables: the volume of the expanders per area of the excised lesions and the hypothetical stretched functional skin width relative to the width of the excised lesions. We also sought to evaluate the relationship between these 2 variables and the need for revision surgery during the postoperative course.Results:The need for revision surgery was statistically higher in patients with a volume of 7 ml/cm2 lesion or less and width of functional skin of less than 2.5 cm/cm lesion (P < 0.05). For scar repairs, the required size and volume of the expanders tended to be larger than those required for any other lesions.Conclusions:Expanders that generate functional skin at least more than 2.5 times the width of the lesion and have a volume more than 7 ml/cm2 lesion are necessary to cover scalp lesions without complications.

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Scalp Stretching with a Tissue Expander for Closure of Scalp Defects

Cited by 76 publications

References 0 publications

Reverse tissue expansion by liposuction deflation for revision of post-surgical thigh scars

Reverse tissue expansion by liposuction deflation for revision of post-surgical thigh scars

Chronic Tissue Expansion

A Retrospective Analysis on the Proper Size of Tissue Expanders to Treat Scalp Lesions

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