Tissue expander complications in plastic surgery: a 10-year experience

Abstract

INTRODUCTION:Tissue expanders have been of great value in plastic surgery. Tissue expansion was developed for a specific indication; however, within a very short time, the concept of tissue expansion found wide applicability. From 1990 to 1999, 315 expanders in 164 patients were utilized. A retrospective analysis of complications and prognostic factors for complications were done. METHODS:The indications for tissue expansion were burns (50%), trauma (32%), and sequelae of previous surgery (8.8%). The expanders were inserted most frequently in the scalp, trunk and neck.RESULTS: There were 22.2% of complications and the most common were expander exposure (50%), infection (24%) and bad function of the expander (12.8%). The present study revealed an increased rate of minor complications in the group of 0 to 10 years of age and an increased rate of major complications for face and neck expansions compared to trunk expansion. There were no increased complication rates for the other age and anatomic site groups, previous expansion, concomitant expansion and type of expander used. CONCLUSIONS:The outcomes from tissue expansion procedures done in our hospital are similar to those reported in the literature. Tissue expansion is a good and safe technique.

First experience of endoscopic implantation of tissue expanders in plastic and reconstructive surgery

“…These complications exerted a negative influence on the efficiency of the tissue expansion, its duration, and the results of the treatment. Our statistics correspond to those documented in the literature database [2,6,7,9,10,15,19]. Wound dehiscence and pressure sores, which tended to develop at sites overlying the expanders, were seen in combination with complications related to the implantation itself (seroma, hematoma, and infection) in 72.5% and 64.7% of patients, respectively .…”

“…According to reports in the literature, the average duration of the expansion process is 2-3 months, and the rate of complications varies from 5% to 39% and can be as high as 70% [2,6,7,9,10,15,19]. This high risk of complications considerably restricts the wide practical application of tissue expansion.…”

Distant blunt forceps dissection in tissue expander insertion: A novel technique

“…While our overall complication rates are comparable with those reported in the literature of open approaches, we found lower rates of hematoma formation and expander extrusion than in open or endoscopic approaches (4,8,9). We hypothesize that the low incidence of hematoma of only one in 30 procedures is explained, in part, by the combination of tumescent hydrodissection and blunt dissection and, furthermore, postulate that this technique helps preserve and circumvent skin-perforating vessels, thus decreasing the incidence of hematomas.…”

Total cheek resurfacing with split ascending neck flap: A new approach

“…Tissue expansion has allowed the reconstructive surgeons to achieve functional and esthetic goals that were previously unobtainable and made wider possibilities for cervical, pectoral and shoulder skin usage for burned cheek resurfacing [19][20][21][22]; but neck skin is thin; therefore, high rate complications occur, especially in children [23][24][25][26]. The balloon dermotension was widely used in our institute.…”