Use of overinflated tissue expanders in the surgical repair of head and neck scars

Postburn head and neck reconstruction using tissue expanders

“…So the added tissue gained by rectangular expanders may increase the choices possible for flap design as compared to round hemispherical devices. 5 The complication rate in our study was 23%; this rate was lower than that of Youssef Saleh (34.75%), 12 and Farhad Hafezi et al (27%) 13 , however; similar result were found with Hudson (25%) 5 and Tavares Filho et al (24%). 14 Our failure rate (interruption of expansion process) was 10% (three cases). This is lower than that of Hudson (20%), 5 comparable to that of Youssef Saleh (13.25%), 12 but higher than that of Farhad Hafezi et al (6%).…”

“…5 It is higher than that achieved by Bozkurt et al who had completely reconstructed 71.6% of their patients 11 but lower than the results of the study of Youssef Saleh 87.5% 12 and Farhad Hafezi et al which was 90%. 13 In our study, rectangular shape of expanders were used in 18 patients (60%). Rectangular shaped tissue expanders are preferred in head and neck reconstruction because it provides 40% tissue gain which is much higher than that achieved by round expanders (25%) and crescent expanders (35%).…”

“…This is lower than that of Hudson (20%), 5 comparable to that of Youssef Saleh (13.25%), 12 but higher than that of Farhad Hafezi et al (6%). 13 There are different reasons for the abovementioned complications. Shortage of a specific shape and size of expander for the patients resulted in selecting other available types.…”

Complications of tissue expansion in the head and neck

“…Interestingly, there were 18 (18/7009; 0.25%) complications related to port site leakage arising from three separate studies included in this systematic review . In one study, the expanders were salvaged by exteriorizing the buried port, and the connective tube was occluded with a clip.…”

Cellular and Molecular Responses to Mechanical Expansion of Tissue

“…Since the first utilization in 1957 (Neumann, 1957), the use of tissue expansions have become widespread in maxillary and craniofacial surgery (Kobus, 2007), burn scar excision (Hafezi et al, 2009), breast reconstruction following mastectomy (Lohsiriwat et al, 2013), ophthalmology (Hou et al, 2012), management of omphalocele (Clifton et al, 2011), nasal reconstruction (Kheradmand et al, 2011), scalp alopecia (Guzey et al, 2015) and other deformities in plastic reconstructive surgery (Motamed et al, 2008; Laurence et al, 2012; Santiago et al, 2012). Tissue expander generates new tissues, by exploiting the viscoelastic properties of the skin and adjusted histological changes which follows the principle of the controlled mechanical skin overstretch (Argenta, 1984; Pamplona et al, 2014).…”