Soft-Tissue Expansion: Concepts and Complications

Can we put a simplified algorithm for reconstruction of large scalp defects following tumor resection?

“…The use of tissue expansion is an option to increase the possibility of primary closure but unfortunately this option was not suitable for most of our patients for many reasons: most of the defects were too large for this technique; many patients had a lack of skin pliability and some had recurrent tumors or received radiotherapy; in addition this technique is neither free of complications nor suitable for immediate coverage [6,14]. …”

“…Primary closure either immediate or delayed remains the simplest option with hairy coverage; however it is not easy in cases with large defects which are more than 50 cm 2 [5]. The use of tissue expansion allows a larger area of coverage with satisfactory results, however, it has limitations for size coverage and it is not free of morbidities [6]. …”

Compression neuropathy of the median nerve during tissue expansion of the forearm

“…This technique has allowed the surgeon to replace lost or surgically excised tissue with neighbouring tissues of similar colour, texture, sensation and thickness, with little donor site morbidity. Complications associated with soft tissue expansion have been reported with varying incidence, which typically delay reconstruction but do not result in loss of tissue (7). Major complications of tissue expansion resulting in removal or replacement of tissue expander include infection, implant exposure, hematoma and extrusion.…”

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

“…In fact, this modality holds significant reconstructive benefits despite certain drawbacks. Common complications associated with tissue expansion techniques include infections, early and late formation of seromas and hematomas in the expander pocket, and extrusion of the tissue expander, usually necessitating its removal (3). Furthermore, actual wound healing following the expander insertion surgery itself can delay tissue expansion and may increase overall morbidity (4).…”