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 217 records · Page 12Linked to original sources

Accurate assessment of tissue expansion in the lower face and anterior neck by a simple measurement technique.

A simple, precise method of clinical estimation for the accurate assessment of tissue expansion in the lower face and anterior neck is described using fixed anatomical reference points. The method makes it possible to select the most suitable size of tissue expander and to decide the optimal timing of operation. By recording the baseline data before expansion and repeating measurements as expansion proceeds, the discrepancy of the expectation between the surgeon and patient concerning the postoperative result can also be minimised.

Cicatrix↗

Tissue expansion of the lower limb: complications in a cohort of 103 cases.

Over 10 years we performed 103 skin-expansion procedures and placed 207 prostheses on lower limbs, using the same surgical protocol. In 83 cases (80.6%) the expansion was achieved without complications. We recorded 20 complications in all (19.4%). Major complications included sepsis, damage due to undermining, exposure of the prosthesis and necrosis of the flap in 16 cases (15.5%), resulting in complete failure of the method in five cases (4.9%). In all, nine patients had septic complications (8.7% of the patients and 45% of the complications), five had exposure of the prosthesis and two had skin necrosis after expansion. Infection and skin necrosis, which are the main causes of failure of this method, can be prevented by a strict surgical protocolcovering all stages of the procedure. Atraumatic undermining, remote and external valves, suction drains in the cavities, advancement flaps and plaster casts after surgery can help to prevent skin necrosis. A separate and remote approach for each prosthesis can prevent infection of all the prostheses and complete failure of the expansion procedure.

Adolescent↗

Candida colonisation within a silicone tissue expander.

The fungal contamination of tissue expanders is rarely reported. There are, however, occasional reports of fungi in association with inflatable mammary implants. We describe the colonisation of a tissue expander with Candida albicans, resulting in the fluid becoming a turbid brown colour. The possible modes of inoculation and survival of the microorganism within the expander shell were investigated by means of biochemical and microbiological analyses of the fluid. The colonisation of silicone implants by opportunistic fungi is probably more common than has been reported, and precautions that can be taken to avoid this complication are emphasised.

Breast Implants↗

[The balloon dissector in expander treatment: A ten-year experience in plastic and reconstructive surgery].

BACKGROUND: The use of the balloon dissector ("space maker") for the implantation of soft tissue expanders is illustrated and technical aspects and advantages are compared to the conventional method. PATIENTS AND METHODS: Over a 10-year period a group of 90 patients with evaluation records (m = 34, f = 56) was analysed retrospectively. The mean age was 23 years (range: 5 to 62 years). Overall, 164 expanders were implanted and in 73 cases (44.5%) a balloon dissector was used. RESULTS: The mean intraoperative expander filling was increased up to 27% of the volume of the tissue expander after using the balloon dissector; in contrast it was 15% after conventional dissection. The mean duration of expansion was decreased by 9.8% after space maker dissection. CONCLUSION: The use of the space maker is a scar-sparing technique. Time of operation and overall duration of expansion are reduced. Patient comfort is clearly improved. The negligible costs of a space maker are compensated by the cost reduction due to shorter operating time, fewer outpatient contacts and a low complication rate. The indications for the use of balloon dissectors are the expansion of skin (scar correction after burns, trauma, tumour), breast reconstruction and augmentation, and the prefabrication and rapid intraoperative expansion of musculocutaneous flaps.

Adolescent↗

Comparative study between acute intraoperative arterial elongation and the use of the interpositional vein graft for arterial reconstruction.

This study compares the acute intraoperative arterial elongation technique with the interposition vein-graft method for the closure of small arterial gaps that cannot be repaired by undermining alone. Ten conditioned female mongrel dogs were divided into two groups: a vein graft interposition group and an acute expansion-elongation group. In ten cases, a 25-mm segment of the superficial femoral artery was excised. The resultant defect, measuring 45 to 60 mm, was repaired by an interpositional graft of a comparable size segment of the superficial femoral vein. In ten other cases, a same-size defect was repaired by a tension-free end-to-end anastomosis, following acute intraoperative arterial elongation. The animals were explored at various intervals. Overall results revealed a 100 percent patency rate with the acute expansion-elongation group vs. 80 percent with the vein-graft interposition group. The versatility, time saving, and ease of technique, plus previous clinical experience, is encouraging enough to recommend this method for the sound repair of small arterial defects in clinical cases.

Anastomosis, Surgical↗

Fascia-vascularized vs. muscle-vascularized prefabricated flaps using tissue expanders: an experimental study in a rat model.

The aim of this study was to compare the applicability and viability of a fascia-vascularized pedicle (FVP) with those of a muscle-vascularized pedicle (MVP) in the prefabrication of a secondary vascularized pedicle flap using a tissue expander. Experiments were carried out in 32 male Wistar rats. The animals were divided into two groups--Group 1 (n = 10), using a skeletonized pedicle of the right saphenous artery, vein, and nerve with a segment of 8 x 10 mm fascia on its distal end (FVP group); and Group 2 (n = 10), using a 3-mm perivascular cuff of muscle with a segment of 8 x 10 mm fascia and gracilis muscle on its distal end (MVP group). The experiments demonstrated that there was a larger area of flap survival in the expanded muscle-vascularized pedicle flaps (96.6 +/- 3.6 percent) than that found in the expanded fascia-vascularized pedicle flaps (83.0 +/- 14.4 percent) in this rat model (p < 0.005). The microangiography of the flaps showed increased vascularity of the muscle cuff at the end of the vascular pedicle in Group 2.

Angiography↗

Acute intraoperative arterial elongation: histologic, morphologic, and vascular reactivity studies.

This study focuses on the histomorphologic damage produced by an acute elongation process, as well as on quantifying the alterations in arterial contractility following the application of this technique. Light microscopy and scanning electron microscopy studies were prepared from expanded and non-expanded pig superficial femoral arteries (SFA) harvested immediately following expansion, and again at 24- and 72-hr intervals. Histologically, the expanded vessels showed minor, patchy, endothelial slough, but not fragmentation of the internal or external elastic lamina. At 24 hr, the endothelium showed reactive changes, but no evidence of smooth-muscle necrosis of the tunica media was observed. At 72 hr, healing of the endothelium was evident by SEM. Similar specimens, also from the SFA, were harvested and placed in organ chambers immediately following expansion and 24 hr later, to measure contractility when exposed to alpha-adrenergic agonists. The vessels were exposed to the contractile agonists, phenylephrine and 5-hydroxytryptamine, which evoked similar concentration-dependent increases in tension in both the expanded group and the controls. From these observations, the authors conclude that acute intraoperative elongation of arteries results in only minor endothelial damage, without affecting the inherent contractility of the vessel wall.

Anastomosis, Surgical↗

Clinical applications of acute intraoperative arterial elongation.

This study reports four clinical cases in which acute intraoperative, extraluminal, arterial elongation was utilized. This technique was developed to facilitate end-to-end anastomoses across vascular defects traditionally bridged with vein grafts. In the reported cases, arterial defects, ranging from 17 to 25 mm, were closed primarily following the application of this technique. Follow-up, ranging from 3 to 34 months, has demonstrated patency in all cases. The authors believe this technique can be used clinically as a reliable alternative to vein grafting for the reconstruction of certain arterial defects.

Adolescent↗

Pulmonary agenesis in a newborn: implantation of tissue expander to prevent a mediastinal shift.

Unilateral pulmonary agenesis is a rare congenital anomaly whose aetiology is not completely known. Vitamin A deficiency, viral agents, or genetic factors are discussed. The incidence was estimated at 1 in 10,000-15,000 autopsies by several authors. Associated malformations, mainly affecting the cardiovascular, gastrointestinal, and musculoskeletal system influence the prognosis of patients as does the location of the missing lung. We report the implantation of a tissue-expander in a three-months-old infant suffering from a right-sided lung agenesis associated with sinus-venosus defect. Other malformations were excluded by sonographic methods. Mediastinal shift with dextropositio cordis in compensatory emphysema of the left lung and frequent infections were the cardinal symptoms. These led to cardiopulmonary decompensation twice. The implantation of the tissue-expander was performed following an aortopexy, which was only temporarily successful. This method allows the filler to be adapted with age to the pleural volume by instillation of sterile saline solution via a microport. Whether or not thorax deformities and scoliosis will be prevented cannot be predicted exactly at this time.

Adult↗

[Epidermal proliferation rate after skin expansion in the dog model].

The aim of this study was to evaluate the time course of the epidermal proliferation under the influence of skin expansion. Therefore 99 expanders were implanted in 18 beagles. The expansion times were between 2 hours and 4 months. Cells in the S-phase were marked by in vivo application of bromodesoxyuridine (BrdU). The tissue specimens were immunohistochemically stained and positive nuclei counted. The proliferation index increased markedly about 32 hours after the onset of the expansion and decreased afterwards slowly during the first week. Because the dog is the most appropriate species for experimental expansion studies (4,5) it can be assumed that skin expansion leads to a stimulation of the epidermal proliferation during the first few days also under clinical conditions. Nevertheless, the amount of skin that can be surgically used depends not only on the characteristics of the epidermal layer, but also on the dermis with its strong fibre system. Own studies published elsewhere (8) have shown that the dermal fibres react much slower to the expansion stimulus, so that even though there is an early epidermal proliferation increase new surgically applicable skin can only be produced by long-term expansion.

Animals↗

Tissue expansion facilitates operation of large myelomeningoceles.

Two children had delayed operations for large myelomeningoceles. As a preparatory operation one silicon tissue expander was inserted on each side of the lesion and successively inflated by weekly injections of saline. After an expansion time of 5 to 6 weeks the definitive procedure was performed. The newly formed fibrous capsule greatly facilitated the reconstruction of the spinal canal. The surplus of skin and subcutaneous tissue allowed the large defects to be easily close in the midline. Both children managed quite well postoperatively.

Cerebrospinal Fluid Shunts↗