Postburn head and neck reconstruction using tissue expanders
Keywords:Tissue expander, postburn scar, alopecia
Background and objective: Tissue expanders are useful adjuvant in reconstruction after burn. The technique provides tissue of similar texture and color to the defect to be covered and has the added advantage of minimal donor site morbidity. The study aimed to assess the outcome and complications of using tissue expansion for head and neck postburn reconstruction.
Methods: Thirty patients with head and neck burn scar, treated with thirty eight tissue expanders, were included in this prospective study at the Plastic Surgery Department in Rizgari Teaching Hospital in Erbil from April 2009 to November 2012, with the mean age of 14 years. Statistical package for social sciences (SPSS version 18) was used for data entry and analysis.
Results: The commonest use of tissue expander was for treating postburn scar alopecia (18 patients, 60%), followed by postburn cheek scar (six patients 20%). The scar size ranged from 4x10cm to 16x24cm. Complete burn scar excision was possible in 80% of cases with single or multiple sessions of expansion. Early exposure of the expander followed by infection occurred in three cases (10%), which led to interruption of the expansion and expander removal. Satisfactory results were achieved after reconstruction in 90% of cases.
Conclusion: Tissue expansion, if carefully planned and conducted, is one of the treatments of choice for post-burn reconstruction of the head and neck, allowing an expanded flap suitable for versatile coverage.
Bauer S, Margulis A. The expanded transposition flap: shifting paradigms based on experience gained from two decades of pediatric tissue. Plast Reconstr Surg 2004; 114:98-106.
Leighton W, Jhonson M, Frie J. Use of temporary tissue expansion in the treatment of post traumatic scalp alopecia, Plast Recon Surg 1986; 77:737-43.
Argenta L, Marks M. Principles of tissue expansion. Stephen J. Mathes. Plastic surgery. 2nd edition. Philadelphia: Saunders-Elsevier; 2006. P. 539-66.
Argenta L,Watanabe M, Grabb W. The use of tissue expansion in head and neck reconstruction. Ann Plast Surg 1983; 11:31.
Hudson A, Grob M. Optimizing results with tissue expansion:10 simple rules for successful tissue expander insertion. BURNS 2005; 31:1-4.
Bauer B. Tissue expansion.In: Beasley RW, Aston S, Bartlatt S, Gurtner G, Spear S. Grabb and Smith`s plastic surgery. 6th edition. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2007.
Foustanos A, Zavrides H. Reconstruction of facial burn sequelae utilizing tissue expanders with embodiment injection site: case report. Acta 2006; 48:5-8.
Motamed S, Niazi F, Atarian S, Motamed A. Post-burn head and neck reconstruction using tissue expanders. BURNS 2008; 34:878-84
Hudson D, Lazarus D, Silfen R. The use of tissue expansion in pediatric plastic surgery.Ann Plast Surg 2000; 45(6):589-94.
Lasheen E, Saad K, Raslan M. External tissue expansion in head and neck reconstruction. J Plast Reconstr Aesthet Surg 2009; 62(8):251-4.
Bozkurt A, Gregor A, Dey D, Vogeler F. Retrospective analysis of tissue expansion in reconstructive burn surgery: Evaluation of complication rates. BURNS 2008; 34:1113-8.
Saleh Y. Scalp reconstruction using tissue expander. Egypt J Plast Reconstr Surg 2004; 28:71-5.
Hafezi F, Naghibzadeh B, Pegahmer M. Use of overinflated tissue expanders in the surgical repair of head and neck scars. JPRAS 2008; 20:1-8.
Tavares M, Belerique M, Franco D, Porchat A, Franco T. Tissue expansion in burn sequelae repair. BURNS 2007; 33:246-51.
Hromadka M, Deschamps J, Sawan K, Elamm C. Delayed development of toxic shock syndrome following abdominal tissue expansion in a pediatric reconstruction patient: case report. Ann Plast Surg 2010; 64(2):254-7.
Kotb M, Soliman M. Guidelines to Minimize the Complications of Tissue Expansion. Egypt J Plast Reconstr Surg 2007; 31(1):79-82.
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