Evolution of the concept of tissue expansion.
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Biomedical subjects
Publications and source records attributed to E D Austad.
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In this article the authors summarize statistical data from 19 patients obtained during quantitative analysis of the thickness of expanded skin and soft tissues utilizing silicone expander procedures. Histopathologic and ultrastructural changes that take place in individual levels of expanded tissues are also illustrated.
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Tissue expansion results in an increase in the total population of epidermal cells: a dividend. The dermis thins initially, but probably reconstitutes over time.
Appropriate patient selection, proper informed consent, and a calm and thoughtful approach to problems of implant deflation, infection, and exposure should prevent true "disasters" in tissue expansion.
Epidermal mitotic activity during tissue expansion has been assessed in the guinea pig using tritiated thymidine and other confirmatory techniques. Implant inflation results in a threefold elevation of epidermal mitotic activity within 24 hours, followed by a gradual return to normal baseline over 2 to 5 days. Implant deflation, conversely, causes a transient decrease in epidermal mitotic activity. Neither of these phenomena has been previously described. It confirms previous animal studies which illustrate the highly responsive nature of the epidermis to physical stimuli and supports the view that tissue expansion is a highly useful manipulation of normal physiologic processes.