Systematic Review of Tissue Expansion: Utilization in Non-breast Applications

Langdell, Hannah C.; Taskindoust, Mahsa; Levites, Heather A.; Mateas, Catalin; Sergesketter, Amanda R.; Kaplan, Samantha; Marcus, Jeffrey R.; Erdmann, Detlev

doi:10.1097/gox.0000000000003378

Cited by 13 publications

(10 citation statements)

References 180 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1,[3][4][5] Despite advancements in reconstruction, TE is not without problems, including a lengthy expansion process, multiple operations, frequent clinical visits, and a cosmetic deformity during the expansion that may upset patients and their families. 11,12 In addition, frequent postoperative complications have been described following expansion. 5,6,[12][13][14] The overall complication rate of 5.7% reported in the NSQIP-P was much lower than rates between 12% and 40% described in smaller single-site retrospective reviews.…”

Section: Discussionmentioning

confidence: 99%

Pediatric Tissue Expansion: Analysis of the National Surgical Quality Improvement Program–Pediatric

Harrison

Rizvi²,

Parsa³

et al. 2022

Journal of Craniofacial Surgery

View full text Add to dashboard Cite

Introduction: Tissue expansion (TE) in pediatric surgery provides vascularized tissue to attain functional and esthetic goals in a broad range of reconstructive procedures. Our study evaluates the demographic, operative, and short-term outcomes of TE in pediatric patients utilizing the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database and highlights factors associated with postoperative complications. Materials and Methods: Retrospective review of a large multicenter database of 402 pediatric patients that underwent TE within the NSQIP-P database from 2013 to 2020 at freestanding general acute care children's hospitals, children's hospitals within a larger hospital, specialty children's hospitals, or general acute care hospitals with a pediatric wing. Patient demographics, clinical risk factors, operative information, and postoperative outcomes were collected with an odds ratio analysis of risk factors. Results: Patients were majority female (55.5%), White (63.2%), and non-Hispanic (67.4%). The minority were born prematurely (11.9%) and had congenital malformations (16.7%). Complications occurred in 5.7%, unplanned readmission in 4.5%, and unplanned operation in 6.5% of patients. Complications lead to readmission in 2.5% and return to the operating room in 3.2% of patients. American Society of Anesthesiology (ASA) score III-IV, congenital malformations, > 1-day hospital stay, and pulmonary, neurologic, and hematologic comorbidities were associated with the greatest increase in odds of complication. Conclusion:This study utilizes the NSQIP-P to provide a comprehensive multicenter view of pediatric patients undergoing TE. Increased understanding of risk factors for complications allows for guidance in patient selection and helps in achieving favorable surgical outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Pediatric Tissue Expansion: Analysis of the National Surgical Quality Improvement Program–Pediatric

Harrison

Rizvi²,

Parsa³

et al. 2022

Journal of Craniofacial Surgery

View full text Add to dashboard Cite

show abstract

“…Super thin abdominal skin pedicle flap has only one pedicle from one site of the abdomen and needs a tissue expander for a larger defect [8] . The tissue expander adds cost and can lead to complications such as failure, infection, and being exposed [9] . Techniques using thin glove-like abdominal flap in subcutaneous layer plane have been published mainly for reconstruction for acute hand burn injuries.…”

Section: Discussionmentioning

confidence: 99%

The use of modified glove-like abdominal flap for reconstruction of contracture following burns of dorsal hand and fingers: A case report

Putri

Runisa

Hasibuan

et al. 2022

International Journal of Surgery Case Reports

View full text Add to dashboard Cite

“…A previous metaanalysis of scalp tissue expander safety has shown infection rates of 2.7%, tissue expander exposure rates of 2.7%, and exposure of implant in 8.1% of cases. 20 However, the quality of the initial scalp tissue, history of previous surgeries, prior infection, patient comorbidities, and desired scalp recruitment can all greatly increase the risk profile. In our cohort, there was one infection and one exposed expander, but in both cases, the tissue had sufficient expansion to proceed with cranioplasty.…”

Section: Discussionmentioning

confidence: 99%

“…Presented is a series of extended scalp expansions demonstrating the upper limit of recruiting large amounts of hair-bearing scalp tissue, with up to 550 cc tissue expanders used. A previous metaanalysis of scalp tissue expander safety has shown infection rates of 2.7%, tissue expander exposure rates of 2.7%, and exposure of implant in 8.1% of cases 20 . However, the quality of the initial scalp tissue, history of previous surgeries, prior infection, patient comorbidities, and desired scalp recruitment can all greatly increase the risk profile.…”

Section: Discussionmentioning

confidence: 99%

Extended Scalp Expansion for Larger Defects During Staged Cranioplasty

Dinis

Junn

Kahle

et al. 2021

Journal of Craniofacial Surgery

View full text Add to dashboard Cite

Background: Secondary cranioplasty is often required following trauma, infection, radiation, or oncologic care, but is complicated by soft-tissue deficits with limited regional options. Scalp tissue expanders can provide hair-bearing, vascularized tissue for tensionfree closure yielding optimal aesthetic results. However, the upper limit of safe scalp expansion has not been explored. This study sought to evaluate the efficacy of extended scalp tissue expansion for challenging cranioplasties in a consecutive series. Methods: Patients who underwent scalp tissue expansion before cranioplasty were retrospectively identified from a single institution between the years 2017 and 2020. Patient demographics, tissue expansion characteristics, and complications during expansion and after cranioplasty were collected. Results: Six patients were identified who underwent staged scalp expansion for cranioplasty; 5 were male (83.3%) with a mean age of 43.8 AE 12.5 years. Indications for cranioplasty included 2 epilepsyrelated procedures, 1 oligodendroglioma, 2 infectious processes, and 1 traumatic incident. A single expander was used in 5 cases, whereas 2 were used in the remaining case. The average expander fill volume was 434.3 AE 115 ccs with a mean expansion time of 3.3 AE 1.4 months. Expander infection occurred in 1 case and expander exposure in another, but adequate scalp expansion was still achieved in both. Successful closure over cranioplasty was obtained in 5 cases (83.3%); 1 patient ultimately required free flap reconstruction for soft-tissue coverage. Conclusions: In cases of extended scalp defects, scalp tissue expansion remains the preferred method for recruiting large quantities of like tissue before implant cranioplasty.

show abstract

Systematic Review of Tissue Expansion: Utilization in Non-breast Applications

Abstract: Supplemental Digital Content is available in the text.

Cited by 13 publications

References 180 publications

Pediatric Tissue Expansion: Analysis of the National Surgical Quality Improvement Program–Pediatric

Pediatric Tissue Expansion: Analysis of the National Surgical Quality Improvement Program–Pediatric

The use of modified glove-like abdominal flap for reconstruction of contracture following burns of dorsal hand and fingers: A case report

Extended Scalp Expansion for Larger Defects During Staged Cranioplasty

Contact Info

Product

Resources

About