Endoscopic-Assisted Neck Tissue Expansion in Reconstruction of Facial Burn Injuries

Kamran, Ali; Salehi, Seyed Hamid; Shoar, Saeed; Hashemian, Seyed Jafar; Moradi, Masoud

doi:10.1097/scs.0000000000000502

Cited by 6 publications

(2 citation statements)

References 14 publications

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“…Skin soft-tissue expansion is widely used in repairing skin or soft tissue defects induced by various causes, such as incision of congenital giant nevus, scars, tumors, and skin defects after trauma. Following the wide application of expanders, numerous studies have reported an increasing number of expanded skin flap uses (6)(7)(8). However, the use of a flap has also been associated with some complications such as necrosis, infection, and hematoma.…”

Section: Discussionmentioning

confidence: 99%

Testing the circulation of expanded flaps—prevention of necrosis of expanded flaps (a clinic study)

Han

Chen

et al. 2023

Front. Pediatr.

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BackgroundExpanded flaps are commonly used in plastic surgery. Although expanded flaps are more resistant to hypoxia than unexpanded flaps, flap necrosis can sometimes occur, particularly with skin incisions of regular proportion. Distal skin necrosis of the expansion flap can be avoided by careful design; however, the utilization rate of the expansion flap decreases. Consequently, successfully avoiding distal skin flap necrosis remains a challenge. In this study, we designed a device for testing the circulation of the expanded flap that can decrease the risk of expanded flap necrosis, thus maximizing the use of an expanded flap.MethodsA total of 128 patients who underwent surgical repair between 2011 and 2019 and were retrospectively examined with the device for testing the circulation of the expanded flap were included in the study. The procedure included (1) making a device for testing the circulation, (2) implanting a skin expander, (3) injecting normal saline into the skin expander, (4) testing the circulation of the expanded flap, and (5) transferring the expanded flap to repair the defect.ResultsOne hundred forty-eight expanded flaps were implanted in 128 patients. The expanded flap that was transferred to repair the defect had no necrosis or infection. None of the expanded flaps with separated blood supply, which could be observed during operations, revealed complications. The survival rates of the expanded flap were increased by testing the circulation of the expanded flap. Expanded flaps designed by this method showed no swelling or paleness and no obvious temperature changes. In addition, the length-to-width ratio could be extended to 3:1.ConclusionsOur proposed method resulted in an effective surgical procedure for the repair of tissue defects. This approach could effectively change the direction of the blood vessel of the expanded skin flap and prevent necrosis of the expanded flap, thus representing a practical way to increase the use of expanded flaps and the flap survival rate, making the whole expanded flap transfer procedure more convenient.

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Section: Discussionmentioning

confidence: 99%

Testing the circulation of expanded flaps—prevention of necrosis of expanded flaps (a clinic study)

Han

Chen

et al. 2023

Front. Pediatr.

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“…Minimally invasive endoscopic techniques have been described for expander placement. 72,73 Various authors have described attempts to enhance and facilitate the expansion process pharmaceutically. 74,75 Self-inflating osmotic expanders have also recently been described that do not require painful injections for inflation.…”

Section: Future Directionsmentioning

confidence: 99%

50 Tissue Expansion in Facial Reconstruction

Papel¹,

Frodel²,

Holt³

et al. 2016

Facial Plastic and Reconstructive Surgery

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Complications of tissue expansion in the head and neck

et al. 2019

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Background The authors aim to present a comprehensive review detailing the present state of evidence with regard to complications following tissue expansion in the head and neck. Methods A systematic literature search was conducted to identify all studies reporting complications of tissue expansion in the head and neck between 2000 and 2019. Subgroup comparisons based on expander locations and planes were conducted. Results A total of 7058 patients were included. Tissue expansion was associated with an overall complication rate of 8.73% (616/7058). The most common complications were extrusion (207/7009; 3.0%) and hematoma (200/7009; 2.9%). Overall complications were highest in the scalp (65/238; 27.3%) and lowest in the mastoid (347/5688; 6.1%). Complications were more common with expansion in the non‐subcutaneous plane (63/590; 10.7%). Conclusion In the absence of large clinical trials, systematic reviews such as these can help inform clinical guidelines and provide practitioners with an evidence‐based reference to improve informed consent.

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Endoscopic-Assisted Neck Tissue Expansion in Reconstruction of Facial Burn Injuries

Cited by 6 publications

References 14 publications

Testing the circulation of expanded flaps—prevention of necrosis of expanded flaps (a clinic study)

Testing the circulation of expanded flaps—prevention of necrosis of expanded flaps (a clinic study)

50 Tissue Expansion in Facial Reconstruction

Complications of tissue expansion in the head and neck

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