Refinements of Tissue Expansion for Pediatric Forehead Reconstruction: A 13-Year Experience

Gosain, Arun K.; Zochowski, Christopher G.; Cortes, Wilberto

doi:10.1097/prs.0b013e3181babc49

Cited by 48 publications

(49 citation statements)

References 24 publications

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“…Entre los modelos de reconstrucción frontal más empleados encontramos colgajos miocutáneos (4), injertos cutáneos, el colgajo radial de antebrazo, el colgajo de dorsal ancho (8), pasando también por el uso de expansores cutáneos (10,11), cada uno con sus indicaciones precisas y con sus ventajas y desventajas.…”

Section: Discussionunclassified

Reconstrucción estética de la frente en carcinoma basocelular

Abullarade

2014

Cir. plást. iberolatinoam.

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ResumenLa frente es una de las áreas más difíciles de reconstruir debido a su propia anatomía, la piel es firme, gruesa, y escasamente elástica. Esto ha supuesto un reto para muchos, y a algunos nos ha llevado a tratar de innovar en la reconstrucción de esta zona anatómica.En este artículo, clasificamos imaginariamente las áreas reconstructivas de la frente de acuerdo a las estructuras vecinas y describimos un tipo de reconstrucción para cada zona en la que movilizamos colgajos rectangulares, siguiendo las líneas naturales de la frente.Palabras clave Frente, Defectos frontales, Reconstrucción frontal, Colgajos locales, Colgajos frontales, Carcinoma basocelular. Nivel de evidencia científica IV AbstractThe forehead is one of the most difficult areas to reconstruct due to its own anatomy; the skin is firm, thick, and unelastic. This has been a challenge for many, and led us to innovate in the reconstruction of this anatomical area.In this article we classify imaginary reconstructive areas of the forehead according to the surrounding structures and describe a type of reconstruction for every zone in which we use rectangular local flaps mobilized following the natural lines of the forehead.

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Section: Discussionunclassified

Reconstrucción estética de la frente en carcinoma basocelular

Abullarade

2014

Cir. plást. iberolatinoam.

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“…There are no good screening techniques for detection of the lesions and the only accepted treatment modality is surgical excision without delay. 1,5 In the literature, the probability of malignant transformation in giant melanocytic lesions, such as cerebriform intradermal nevus is, in contrast, most likely to occur in the first decade. The formidable appearance of the scalp was very stressful condition for the parents.…”

Section: Discussionmentioning

confidence: 99%

“…The use of tissue expanders enables maximum use of the remainder of the scalp in the closure of scalp deformities. 5,7,8 Careful planning prior to treatment of large defects helps prevent complication. Aggressive expansion in high-risk anatomic regions such as scar tissue may cause ischemic ulcerations and increase product failure.…”

Section: Discussionmentioning

confidence: 99%

“…Primary closure is possible after surgical excision of small or localized lesions, while larger lesions require more complicated reconstructive methods, such as tissue expansion applications, prior to excision. [5][6][7] In order to replace the hair-bearing scalp defect, the use of local tissue of similar quality and structure is optimal. For reconstruction of large lesions or defects, tissue expansion presents a useful option.…”

Section: Introductionmentioning

confidence: 99%

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Aesthetic Reconstruction of Congenital Cerebriform Intradermal Nevus by Sequential Tissue Expansion at an Early Age: Ten-year Follow-up

Fırat¹,

Gürlek²,

Ayteki̇n³

et al. 2012

JIUMF

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Cerebriform intradermal nevus (CIN) is a congenital tumoral abnormality of the scalp. The incidence of development of malignant melanoma in CIN can rise up to 10%. Surgical excision of the lesion is the sole treatment modality for CIN. In this case, we present the 10-year follow-up of a 45-day-old infant with congenital CIN covering 75% of his scalp who had scalp reconstruction by sequential tissue expansion. Sequential tissue expansion processes with rectangular-shaped expanders of 450, 400, and 250 ml in size, respectively, were applied over an eight-month period. The interval between the two procedures was two weeks. The tissue expansion technique is a useful option for hair-bearing scalp reconstruction. This technique can be used sequentially or gradually. In order to obtain homogenous follicle distribution, the rest of the scalp should be expanded as much as possible. Careful planning in large defects helps prevent complications. In this case, we applied a sequential tissue expansion procedure when the patient was 45 days old, and the expansion period was continued for eight months. This very early age is a unique case for tissue expansion applications when compared with examples in the literature. On the other hand, we want to underline the aesthetic result of this case rather than the reconstructive method. Reconstruction of huge scalp defects by re-expansion (sequential expansion) and leaving the expander beneath the expanded flap until the sequential procedure decrease flap contracture reduces the required number of operations, and produces better aesthetic outcomes. Key Words: Cerebriform Intradermal Nevus; Tissue Expansion; Sequential Tissue Expansion. Ardışık Doku Genişletme İşlemi ile Konjenital Serebriform İntradermal Nevüsün Erken Yaşta Estetik Rekonstrüksiyonu: 0n Yıllık TakipSerebriform intradermal nevus skalpte görülen konjenital tümoral bir anomalidir. Malign melanoma gelişme insidansı %10'a kadar ulaşabilmektedir. Bu lezyon için cerrahi eksizyon tek tedavi seçeneğidir. Bu vakada, 45 günlük bir bebeğin kafa derisinin %75'ini kaplayan konjenital serebriform intradermal nevusün ardışık doku genişletme metodu ile tedavisinin 10 yıllık takip sonuçlarını sunmaktayız. Ardışık doku genişletme işlemi sırasıyla 450, 400, 250 ml'lik dikdörtgen şekilli doku genişleticilerle sekiz aylık bir sürede uygulandı. Sözkonusu bu üç doku genişletme işlemi arasındaki bekleme süresi 2 hafta idi. Doku genişletme tekniği saçlı deri rekonstrüksiyonunda oldukça etkin bir seçenektir. Bu teknik ardışık veya aşamalı olarak uygulanabilir. Homojen saç folikülü dağılımı elde etmek amacıyla, kalan saçlı deri elverdiği ölçüde genişletilebilir. Geniş defektlerin rekonstrüksiyonunda dikkatli planlama, komplikasyonların önlenmesinde yardımcıdır. Bu vakada, 45 günlük çocuk hastaya ardışık doku genişletme işlemini sekiz ay boyunca uyguladık. Bu vaka, literatürdeki diğer vakalarla kıyaslandığında bu kadar erken yaşta doku genişletici uygulanan tek vakadır. Diğer taraftan, rekonstrüksiyon metodundan ziyade on yıllık estetik sonucu vur...

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“…Some authors prefer a varied number of reconstructions such as myocutaneous [4] and others use expansion [5] or even microsurgery reconstructive methods like radial forearm flap, latissimus dorsi flap, each with its advantages and disadvantages to consider as well as to consider the size of the defect. The cutaneous island flaps [6] or myocutaneous flaps, can leave bulky deficiency and different skin quality characteristics as well as unpredictable scar position at the donor site.…”

Section: Discussionmentioning

confidence: 99%

Aesthetic Considerations in Forehead Reconstruction in Skin Carcinoma

Abullarade¹,

Jezabel²

2013

JCT

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Reconstruction of the forehead has been a challenge for many surgeons. Some use skin grafts, other microvascular flaps, but local flaps for coverage of forehead skin are still the cornerstone principle in providing the ideal skin color and texture. In this article, the forehead is classified into surgical reconstructive subunits. These subunits are set according to the surrounding structures. Flaps are rectangular in shape in mobility in order to follow the natural lines of the forehead.

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Refinements of Tissue Expansion for Pediatric Forehead Reconstruction: A 13-Year Experience

Cited by 48 publications

References 24 publications

Reconstrucción estética de la frente en carcinoma basocelular

Reconstrucción estética de la frente en carcinoma basocelular

Aesthetic Reconstruction of Congenital Cerebriform Intradermal Nevus by Sequential Tissue Expansion at an Early Age: Ten-year Follow-up

Aesthetic Considerations in Forehead Reconstruction in Skin Carcinoma

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