Ten technical considerations revisited in tissue expansion

Geoghegan, Luke; Nikkhah, Dariush

doi:10.1093/jscr/rjaa273

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2024

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Cited by 2 publications

References 11 publications

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Fundamentals of Tissue Expansion

Ferreira-Aparicio

2024

Plastic and Reconstructive Surgery Fundamentals

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Fundamentals of Tissue Expansion

Ferreira-Aparicio

2024

Plastic and Reconstructive Surgery Fundamentals

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Increased Vascularity Is the Basis of Enhanced Viability of Expanded Tissue: A Quest to Prove It with Radiological Assessment

Kumar Rout,

Mallik,

Sahoo

2024

J Skin Stem Cell

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Background: Although tissue expansion is widely used in reconstructive surgery, no specific study has evaluated the vascularity of expanded skin in real-time to determine the safe limits and efficacy of expansion. Objectives: This study aimed to perform a comparative analysis of the vascularity of expanded skin (using remote-valve tissue expanders) pre- and post-expansion with the aid of Color Doppler and CT-angiography. The objective was to assess vascular changes for resurfacing post-burn tissue defects. Methods: This prospective, descriptive, non-randomized, comparative study was conducted over one year, involving three patients with five tissue expanders. Pre-expansion vascularity of the adjacent healthy region (to be expanded) was assessed using Color Doppler (Power mode) and CT-angiography. Parameters measured included intravascular flow velocity, waveforms, lumen diameter, vessel density, and feeder vessels. The tissue expanders were surgically inserted, and saline was used to expand them to the desired limit. Following expansion, radiological investigations were repeated in the expanded regions to compare vascular parameters with pre-expansion findings. Subsequently, the expanders were surgically removed, and final wound closure was achieved. The outcomes were measured using subjective parameters, including the success of expansion, wound healing, adequate coverage of defects, and complications, if any. Results: Of the five expanders placed in three patients, one failed due to infection, resulting in an 80% success rate for tissue expansion. All wounds healed, with ancillary procedures such as expander removal (for the failed expander) and skin grafting fulfilling the surgical objectives. Radiological evidence demonstrated increased neovascularization patterns, including an increased number of feeder vessels and flow reaching the advancing flap edges. Statistical analysis revealed that among all parameters, lumen diameter (measured in mm) via CT-angiography pre- and post-expansion showed significant changes. Conclusions: This study provided real-time radiological evidence of increased vascularity in expanded skin following tissue expansion. The findings support the efficacy of tissue expansion in enhancing vascularization, which contributes to successful reconstructive outcomes.

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Ten technical considerations revisited in tissue expansion

Cited by 2 publications

References 11 publications

Fundamentals of Tissue Expansion

Fundamentals of Tissue Expansion

Increased Vascularity Is the Basis of Enhanced Viability of Expanded Tissue: A Quest to Prove It with Radiological Assessment

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