PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Tissue Expansion Devices”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 181 records · Page 10Linked to original sources
PubMed1996

Ultrex cylinders: problems with uncontrolled lengthening (the S-shaped deformity).

PURPOSE: We investigated whether the AMS Ultrex cylinder, developed to provide cylinder lengthening while controlling girth expansion, acted as a tissue expander and, thus, promoted penile lengthening. MATERIALS AND METHODS: Between December 1990 and January 1992, 59 AMS Ultrex prostheses were implanted. Cylinder length corresponded to intracorporeal measurements. The results of lengthening and occurrence of an S-shaped deformity were statistically analyzed. RESULTS: No penile lengthening occurred. In 19 patients (32%) cylinder replacement was required for the S-shaped deformity. CONCLUSIONS: Ultrex cylinders should be downsized and prolonged inflation should be avoided. They should not be implanted in cases of Peyronie's disease, or to replace malleable or self-contained inflatable implants.

Erectile Dysfunction↗
PubMed2002

Bladder augmentation in dogs using the tissue capsule formed around a perivesical tissue expander.

PURPOSE: Enterocystoplasty provides needed improvement in bladder storage parameters in many patients but it also generates significant morbidity. We evaluated the unusual potential alternative of using the capsule that forms around a standard silicone tissue expander placed perivesically to augment the bladder in dogs. MATERIALS AND METHODS: Six mongrel dogs underwent baseline videourodynamics and assessment of serum electrolytes, followed by placement of a 250 to 500 cc perivesical silicone tissue expander. Four months after implantation the tissue expander was removed and the fibrous capsule around the expander was biopsied. The capsule was opened and anastomosed to the bladder to augment storage. Serum electrolytes were determined 2 and 4 weeks after augmentation. Videourodynamics were repeated after 3 to 5 months, that is at sacrifice. The harvested bladders underwent histological evaluation. RESULTS: Five dogs underwent augmentation as described, while in an additional dog that underwent intraperitoneal placement of the tissue expander a fibrous capsule failed to form. Of the 5 augmented dogs 4 underwent repeat urodynamic and electrolyte evaluation with harvesting of the lower urinary tract, while 1 died of undetermined causes 3 weeks after augmentation. A distinct capsule formed in all dogs and augmentation was technically achievable. Anastomosis calcification in 3 dogs limited filling the augmenting capsule for cystography. Bladder capacity and compliance improved in all animals but it varied in degree. Histological examination of the capsule biopsies showed collagen rich connective tissue without epithelium or smooth muscle. After augmentation the capsular segment revealed urothelium in all cases with squamous metaplasia in 1. The subepithelial region had dense fibrosis and a thin band of osseous metaplasia occupied the lamina propria in all cases. Disorganized smooth muscle bundles were noted in all augmented bladders within the collagen of the capsule wall. CONCLUSIONS: Bladder augmentation with the collagenous capsule formed over a perivesical tissue expander is technically feasible. There was evidence of epithelial and smooth muscle ingrowth from the native bladder with improved bladder capacity and compliance in all dogs. Osseous metaplasia of the luminal surface of the collagen based capsule that developed in all animals may have been responsible for anastomotic narrowing and limited filling on cystography.

Animals↗
PubMed1997

Hepatic vein reconstruction in 152 living-related donor liver transplantation patients.

BACKGROUND: Hepatic vein (HV) reconstruction is crucial in partial liver transplantation in which the inferior vena cava (IVC) is preserved. METHODS: We reviewed the medical records of 152 living-related donor liver transplantations (LRDLTs) in 150 children (45 left lobe grafts, 106 lateral segment grafts, and 1 right lobe graft) monitored for 12 months or longer. RESULTS: A standard technique was a wide end-to-side anastomosis between the donor HV and cuffs, consisting of the recipient middle and left HV and an incision to the IVC. In 15 of 22 partial grafts with two separated HVs the two vessels were reformed by back table surgery to have a common anastomotic orifice, and two separate anastomoses of the individual vessels were made for the remaining seven grafts. Four patients with an absence of infrahepatic IVCs and two with completely obstructed IVCs had end-to-end anastomoses with recipient IVCs. Four patients with stenotic IVCs had end-to-side anastomoses with new orifices on the IVCs. Two patients had acute HV obstruction caused by twisting of the HV that required laparotomy, and six had late-onset HV obstruction that required radiologic intervention. A tissue expander was placed prophylactically in the right subphrenic space in 10 patients to prevent the dislocation of the graft into the right subphrenic space. CONCLUSIONS: It is important in HV reconstruction in partial liver transplantation to make wide orifices and to adapt each graft to its orthotopic place, taking into consideration graft shape, size of the abdominal cavity of the recipient, and anatomic variations in vessels.

Adolescent↗
PubMed2001

Scleral expansion bands for presbyopia.

OBJECTIVE: To evaluate the safety and effectiveness of surgery using scleral expansion bands. DESIGN: Prospective, noncomparative, small case series. PARTICIPANTS: Six subjects were enrolled. Four subjects received implants in one eye and two subjects received implants in both eyes. METHODS: Implantation of the scleral expansion bands (SEB) was performed using Schachar's standard technique. Subjects were observed at six postoperative examination intervals through 1 year. MAIN OUTCOME MEASURES: The key efficacy measures were distance-corrected near visual acuity (at 40 cm and 60 cm) and subjective amplitude of accommodation (push-up, push-down, and minus lens procedures). RESULTS: Distance visual acuity was similar before and after surgery. The near visual acuity and the subjective amplitude of accommodation were temporarily improved in three eyes. However, in the other five eyes, we did not note any improvement of accommodation or near vision after the scleral expansion surgery. CONCLUSIONS: In this study, the outcome of the SEB intervention was characterized by inconsistent and unpredictable results with a low level of patient satisfaction.

Accommodation, Ocular↗
PubMed1993

Controlled tissue expansion in periocular reconstructive surgery.

BACKGROUND: Soft tissue expansion is a technique useful in reconstruction when a shortage of tissue exists. This method allows the creation of skin similar in appearance and type to that immediately adjacent to the defect. The use of this technique as a stage in repairing large periocular defects is presented. The sequence of implant placement, expansion, and ensuing eyelid reconstruction is illustrated. METHODS: The soft tissue adjacent to an eyelid defect was expanded by means of a subcutaneously implanted reservoir that was progressively inflated over several weeks by percutaneous injection of fluid. The prosthesis was removed after adequate expansion had been achieved. The expanded tissue was then used to fashion a local flap to resurface the defect. RESULTS: Upper eyelid skin expansion was performed in one patient, and five patients received expansion in an adjacent area. The expanded tissue was then used to reconstruct the eyelid defect. The only complications encountered were tissue necrosis at the tip of an advancement flap in one patient and hematoma formation within the dissection pocket after expander insertion in another patient. CONCLUSIONS: This technique complements existing reconstructive methods and provides a valuable surgical alternative for managing various periocular defects. The potential application of this technique in eyelid and periocular reconstruction appears promising.

Adolescent↗
PubMed1998

Intraoperative tissue expansion in eyelid reconstruction.

OBJECTIVE: Chronic tissue expansion is a well-accepted modality for increasing available tissue for reconstructive surgery. In rapid intraoperative tissue expansion (RITE), a tissue expander is used intraoperatively to increase the available tissue area for defect closure. The use of the ubiquitous and inexpensive Foley catheter has previously been reported as a tissue expander in RITE. In this paper, the authors examine the application of the Foley catheter for RITE in oculoplastic surgery. DESIGN: Case series. PARTICIPANTS: Twenty-six patients (ages 50 to 87) with eyelid defects from various causes underwent reconstruction using RITE. INTERVENTION: Using this technique, the tip of a #14 French Foley catheter is trimmed, keeping the balloon intact. The balloon is inserted under a skin-muscle flap. Counter traction is applied, and the balloon is filled with saline until the flap blanches. The balloon is inflated twice for 5 minutes with a 1- to 2-minute rest period between expansions. This provides increased tissue area for reconstruction of periocular defects. MAIN OUTCOME MEASURES: The linear extent of the eyelid defect was measured prior to and after expansion with RITE. A comparison was made between the two measurements. RESULTS: The linear extent of the eyelid margin defect decreased by 36% after RITE. CONCLUSIONS: Rapid intraoperative tissue expansion with a Foley catheter is a means of providing increased tissue area for reconstructive surgery of the eyelids and periorbital region. This technique provides excellent tissue match for color, texture, and thickness. The technique decreases the size of the incised and undermined skin-muscle flap and the tension needed for wound closure.

Aged↗
PubMed1990

Tissue expanders.

The use of an inflatable bag to obtain skin for flaps is an exciting new reconstruction procedure in veterinary surgery. The silicone elastomer balloon is placed subcutaneously, adjacent to a defect, and slowly inflated over a period of several weeks. The resulting skin flap can be used to correct the defect or replace the skin loss. The use of this procedure is described in animals.

Animals↗
PubMed2002

Repeated expansion in burn sequela.

This paper presents a retrospective study of the use of 346 expanders in 132 patients operated at the Ivo Pitanguy Clinic, between the period of 1985 and 2000. The expanders were used in the treatment of burn sequela. In the majority of cases, more than one expander was used at the same time. In 42 patients, repeated tissue expansion was done. The re-expanded flaps demonstrated good distension and viability. With the increase in area at each new expansion, larger volume expanders were employed, achieving an adequate advancement of the flaps to remove the injured tissue. The great advantage of using tissue re-expansion in the burned patient is the reconstruction of extensive areas with the same color and texture of neighboring tissues, without the addition of new scars.

Adolescent↗
PubMed2001

Complications and patient satisfaction following expander/implant breast reconstruction with and without radiotherapy.

PURPOSE: To compare the rates of complications and patient satisfaction among breast cancer patients treated with mastectomy and tissue expander/implant reconstruction with and without radiotherapy. METHODS AND MATERIALS: As part of the Michigan Breast Reconstruction Outcome Study (MBROS), breast cancer patients undergoing mastectomy with reconstruction were prospectively evaluated with respect to complications, general patient satisfaction with reconstruction, and esthetic satisfaction. Included in this study was a cohort of women who underwent breast reconstruction using an expander/implant (E/I). A subset of these patients also received radiotherapy (RT). At 1 and 2 years postoperatively, a survey was administered which included 7 items assessing both general satisfaction with their reconstruction and esthetic satisfaction. Complication data were also obtained at the same time points using hospital chart review. Radiotherapy patients identified in the University of Michigan Radiation Oncology database that underwent expander/implant reconstruction but not enrolled in the MBROS study were also added to the analysis. RESULTS: Eighty-one patients underwent mastectomy and E/I reconstruction. Nineteen patients received RT and 62 underwent reconstruction without RT. The median dose delivered to the reconstructed breast/chest wall, including boost, was 60.4 Gy (range, 50.0-66.0 Gy) in 1.8- to 2.0-Gy fractions. With a median follow-up of 31 months from the date of surgery, complications occurred in 68% (13/19) of the RT patients compared to 31% (19/62) in the no RT group (p = 0.006). Twelve of 81 patients (15%) had a breast reconstruction failure. Reconstruction failure was significantly associated with experiencing a complication (p = 0.0001) and the use of radiotherapy (p = 0.005). The observed reconstruction failure rates were 37% (7/19) and 8% (5/62) for patients treated with and without radiotherapy, respectively. Tamoxifen was associated with a borderline risk of complications (p = 0.07) and a significant risk of reconstruction failure (p = 0.01). Sixty-six patients of the study group completed the satisfaction survey; 15 patients did not. To offset potential bias for patients not completing the survey, we analyzed satisfaction data assuming "dissatisfaction" scores for surveys not completed. In the analysis of patients with unilateral E/I placement, reconstruction failure was significantly associated with a lower general satisfaction (p = 0.03). Ten percent of patients experiencing a reconstruction failure were generally satisfied compared to 23% who completed E/I reconstruction. In addition, tamoxifen use was associated with a significantly decreased esthetic satisfaction (p = 0.03). Radiotherapy was not associated with significantly decreased general or esthetic satisfaction. CONCLUSION: Irradiated patients had a higher rate of expander/implant reconstruction failure and complications than nonirradiated patients. Despite these differences, our pilot data suggest that both general satisfaction and patient esthetic satisfaction were not significantly different following radiotherapy compared to patients who did not receive RT. Although statistical power was limited in the present study and larger patient numbers are needed to validate these results, this study suggests comparable patient assessment of cosmetic outcome with or without radiotherapy in women who successfully complete expander/implant reconstruction.

Adult↗
PubMed2003

Radiotherapy and immediate two-stage breast reconstruction with a tissue expander and implant: complications and esthetic results.

PURPOSE: To report complications, failure rate, and esthetic results in patients undergoing immediate breast reconstruction with a tissue expander and implant, with or without adjuvant treatment. METHODS AND MATERIALS: We reviewed the records of the 77 patients who underwent immediate breast reconstruction with an expander/implant between January 1999 and December 2000. Complications were assessed using the Common Toxicity Criteria, version 2, scale. Esthetic results were assessed by the physician using five criteria. RESULTS: Of the 77 patients, 55 had received adjuvant radiotherapy. The median follow-up was 25 months. Complications appeared to correlate with radiotherapy (14% for nonirradiated patients; 51% for irradiated patients; p = 0.006) and adjuvant chemotherapy (54% with chemotherapy [CHT] vs. 25% without CHT; p = 0.02). Breast reconstruction failed in 21% of patients (9% of nonirradiated patients and 24% of irradiated patients; p = 0.1), and chemotherapy was associated with a worse rate of failure (34% with CHT vs. 6% without CHT, p = 0.005). Adjuvant tamoxifen, however, correlated neither with complications (45% with tamoxifen vs. 39% without; p = 0.15) nor with failure (21% with tamoxifen and 23% without, p = 0.79). Esthetic results were acceptable in 60% of cases. CONCLUSION: Immediate breast reconstruction with an expander/implant can be considered even for patients requiring adjuvant treatment. However, the complication and failure rates are three times higher after postexpander radiotherapy.

Adult↗
PubMed1989

Tissue expansion.

Although tissue expansion is unlikely to replace skin grafting and other basic reconstructive procedures in the horse, its continued success in humans will undoubtedly stimulate client interest in its use. Its biggest advantage is the advancement of full-thickness skin over large defects where grafting techniques would not provide the same degree of protection. The resulting cosmetic appearance of the wound is also better.

Animals↗
PubMed1996

Soft tissue expansion prior to arthroplasty in the multiply-operated knee. A new method of preventing catastrophic skin problems.

Ten knees in nine patients underwent gradual soft tissue expansion prior to major knee surgery. All patients had multiple prior operative procedures around the knee. The resultant multiple skin incisions were felt to potentially jeopardize the postoperative status of the soft tissues. Each knee underwent the surgical placement of a tissue expander through a bed of adjacent healthy soft tissue followed by the gradual inflation of the expander over an average of 64.5 days. The average volume of soft tissue expansion was 313.7 mL per knee. Subsequent major knee surgery requiring an arthrotomy was performed at the time of expander removal followed by uncomplicated soft tissue closure. All wounds healed without any complications.

Adult↗