Intraoperative Acute Tissue Expansion Revisited: A Valuable Tool for Challenging Skin Defects

Chandawarkar, Rajiv Y.; Cerviño, Alejandro; Pennington, Gary A.

doi:10.1046/j.1524-4725.2003.29218.x

Cited by 11 publications

(8 citation statements)

References 18 publications

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“…6,7 Chronic expansion induces both mechanical and biological creep and therefore provides significantly greater gains in tissue surface area when compared with acute techniques, which rely solely on mechanical creep. 8 The benefits of chronic expansion techniques are generally accepted in human medicine, while the value of acute techniques is an area of contention, with some critics suggesting they provide no more of an advantage than tissue undermining and advancement. 8 In the human literature, the application of STEDs is indicated for a broad range of conditions including corrective procedures for skin burns, scars, alopecia, and postmastectomy breast reconstruction.…”

Section: Discussionmentioning

confidence: 99%

“…8 The benefits of chronic expansion techniques are generally accepted in human medicine, while the value of acute techniques is an area of contention, with some critics suggesting they provide no more of an advantage than tissue undermining and advancement. 8 In the human literature, the application of STEDs is indicated for a broad range of conditions including corrective procedures for skin burns, scars, alopecia, and postmastectomy breast reconstruction. 9 Its use has also been reported in surgical management of cicatricial ectropion of the lower eyelid, orbital reconstruction after total maxillectomy and upper-and lower-lid reconstruction after a chemical burn.…”

Section: Discussionmentioning

confidence: 99%

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Use of a chronic soft tissue expansion device to facilitate blepharoplasty in a horse with lower‐lid cicatricial ectropion with a 14‐year follow‐up

Whittaker¹,

Reynolds²,

McCarthy³

et al. 2020

Veterinary Ophthalmology

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A 3‐year‐old Thoroughbred filly presented to a referral equine hospital for surgical correction of a severe cicatricial lateral lower eyelid ectropion OD, with secondary exposure keratitis. The severity of the ectropion deemed that conventional ectropion repairs would be unsuccessful. Therefore, a soft tissue expansion device was used to create sufficient local tissue for a rotational graft with tension‐relieving horizontal incisions to be performed to facilitate closure and acceptable eyelid apposition. The keratitis had resolved by two months postoperatively. There were no long‐term complications and only mild recurrence of the keratitis observed 14‐years postoperatively.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Use of a chronic soft tissue expansion device to facilitate blepharoplasty in a horse with lower‐lid cicatricial ectropion with a 14‐year follow‐up

Whittaker¹,

Reynolds²,

McCarthy³

et al. 2020

Veterinary Ophthalmology

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“…The fascia along the temporal line was released while dissection proceeded anteriorly. Galeatomies were performed if extra intraoperative creep and expansion of the posterior scalp was needed . At that conjecture, the brow lift was performed beginning in the midline and working laterally.…”

Section: Methodsmentioning

confidence: 99%

Scalp advancement for transgender women: Closing the gap

2019

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an academic medical center. Sex, gender, age, whether galeatomy was performed, and additional variables were recorded. The distance of hairline advancement was measured in the midline and at the left and right midpupillary line. Galeatomies and rapid intraoperative tissue expansion were performed as per standard surgical protocol.Results: For the group of 29 individuals who underwent the specified method for scalp advancement, the average differences for the glabella to the trichion, the right midpupillary line, and the left midpupillary line were 1.90 cm, 2.07 cm, and 2.07 cm, respectively. These differences between the pre-and post-observations were statistically significant at the 0.1% level (P < .001). The overall average difference in scalp advancement was 2.01 cm (also significantly different pre-and post-measurements at the 0.1% level; P < .001).Conclusions: Our technique of hairline advancement provides a significant improvement in the hairline in patients seeking out advancement due to an elongated forehead while undergoing facial feminization.

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“…The reason for the two-stage rapid expansion is because such staged protocols have been established in surgery for acute tissue expansion [ 21 ], with many authors supporting this method of rapid expansion to achieve additional skin cover during reconstructive surgery [ 22 ]. Further, during the testing phase, this study found this technique consistently caused enough dermo-epidermal shear to cause displacement of the fatty dermis and the creation of whorl patterns.…”

Section: Methodsmentioning

confidence: 99%

Golden Spirals and Scalp Whorls: Nature’s Own Design for Rapid Expansion

Paul

2016

PLoS ONE

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This paper documents what began as an exercise in curiosity—logarithmic spiral designs abound in nature—in galaxies, flowers, even pinecones, and on human scalps as whorls. Why are humans the only primates to have whorls on the scalp? Is the formation of scalp whorls mechanical or genetic? A mechanical theory has long been postulated– the mechanical theory suggests that hair whorl patterning is determined by the tension on the epidermis during rapid expansion of the cranium while the hair follicle is growing downwards—however, this has never before, to the author's knowledge, been experimentally proven conclusively. We found, that under certain conditions, we were able to experimentally recreate spirals on the scalp to demonstrate that the basis of scalp whorls is indeed mechanical—and that logarithmic spirals may be nature’s own design for rapid expansion of organic tissues. Given our experiments only created whorls when certain conditions were satisfied (and not in others), they have given us great insight into the mechanical formation of skin whorls and the physiology of skin stretch. We believe that these findings will lead to many more advances in understanding skin dynamics and indeed the changes that occur in tissue when confronted by stretch.

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Intraoperative Acute Tissue Expansion Revisited: A Valuable Tool for Challenging Skin Defects

Abstract: ATE provides a useful tool for closure of skin defects that are resistant to simple primary closure even when deeply undermined. It is simple and easily performed in an office setting without much preparation or special equipment.

Cited by 11 publications

References 18 publications

Use of a chronic soft tissue expansion device to facilitate blepharoplasty in a horse with lower‐lid cicatricial ectropion with a 14‐year follow‐up

Use of a chronic soft tissue expansion device to facilitate blepharoplasty in a horse with lower‐lid cicatricial ectropion with a 14‐year follow‐up

Scalp advancement for transgender women: Closing the gap

Golden Spirals and Scalp Whorls: Nature’s Own Design for Rapid Expansion

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