CONCEPT OF TISSUE EXPANSION IN RECONSTRUCTIVE SURGERY

Abstract

Sheeja Rajan T. M1, Kader K2, Komal Rani T3

BACKGROUND: Tissue expansion is a unique reconstructive option in the armamentarium of a reconstructive surgeon whereby skin and soft tissues of our body can be stretched to large dimensions for wound coverage. The basis for such stretch ability lies in the inherent viscoelastic properties of skin.

AIMS: This paper explores the prospects of using tissue expanders to reconstruct defects arising due to a kaleidoscope of pathological conditions including burns scars, post traumatic scars, congenital anomalies like hairy nevus, involutional scars in haemangioma as well as in post mastectomy breast reconstruction.

MATERIALS AND METHODS: Our experience with tissue expansion in 14 patients over 24 months is presented. Tissue expanders made of silicone in sizes from 100-250ml, of round, rectangular or croissant (crescent) shapes have been used. Areas expanded include scalp, forehead, neck, abdomen and forearm. Multiple expanders have been used when possible. Average expansion time was 8-12 weeks and the expanded tissue was transferred as advancement flaps.

RESULTS AND CONCLUSIONS: Tissue expansion was successfully completed in 13 patients. Expansion had to be aborted in 1 paediatric patient undergoing neck expansion due to infection. Implant failure occurred in 1 patient during serial expansion. Nevertheless, in our experience tissue expansion is an invaluable reconstructive tool to give excellent donor tissue with colour and texture match in countless situations demanding aesthetic and functional reconstruction.

 

 

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