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Results for “Tissue Expansion Devices”

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At least 433 records · Page 24Linked to original sources
PubMed1993

Scalp extension.

BACKGROUND: Surgery to correct extensive alopecia requires increasing the surface of hair-bearing scalp and removing bald scalp. Two commonly used methods, scalp expansion and scalp reduction, have disadvantages. OBJECTIVE: To describe a new method, scalp extension, that employs a thin sheet of bioplastic (an extender) stretched and attached with hooks to the galea after scalp reduction. METHODS: The surgical technique is described and the results compared with those of patients who have undergone scalp reduction and scalp expansion. A study of the first fifteen cases treated is presented. RESULTS: During the few weeks that the extender is implanted, the constant tension it exerts on the galea causes a progressive stretching of the scalp. Data from the first fifteen cases treated reveal eradication of more extensive bald areas than with scalp reduction, making it possible to cut the number of operations necessary in half while considerably shortening total treatment time. The absence of major side effects, along with the absence of any deformation of the scalp (unlike scalp expansion), explains the excellent acceptability of the instrument by patients. CONCLUSION: Scalp extension appears to be a useful adjunctive technique in hair replacement and reconstructive surgery, and has distinct advantages over standard scalp reduction and tissue expansion techniques.

Alopecia↗
PubMed1993

Scalp lifting. An 8-year experience with over 1,230 cases.

BACKGROUND: This article reviews the author's 8-year experience with extensive scalp-lifting, which includes 1,230 cases. OBJECTIVE: To overview extensive scalp-lifting paying particular attention to the areas of complications and the ways to reduce them. METHOD: Retrospective analysis of 1,230 cases was done. Necrosis, infection, hematoma, numbness, and scarring were evaluated. RESULTS: 1) Vertical incision occipital artery ligatory should be performed 4 to 8 weeks prior to a scalp lift. 2) Use a delay procedure prior to a frontoparietal advancement flap. 3) Use only lateral lifts on patients with prior punch-grafting. 4) Locate the temporal arteries preoperatively with Doppler ultrasonography. 5) Do not perform frontoparietal advancement flaps on patients with prior punch-grafts. CONCLUSION: Scalp lifting is an extremely effective and expedient method to treat alopecia; however, certain precautionary measures must be taken to obtain excellent, consistent results.

Alopecia↗
PubMed1993

A history of tissue expansion. Concepts, controversies, and complications.

BACKGROUND: Tissue expansion has become a widely used adjunct in reconstruction of the skin. OBJECTIVE: To trace the history of the concept of tissue expansion from the ancient to the latest medical literature. METHODS: We reviewed the technologic developments in the materials and methods of tissue expansion. RESULTS: Tissue expansion is of clinical importance and can be understood by the biochemical, biomechanical, and histologic features of expanded skin. CONCLUSION: Tissue expansion is becoming widely used and accepted and its continued use under many circumstances is justified by the experimental and clinical results.

Animals↗
PubMed1993

Comparison of skin hooks and Foley catheters for immediate tissue expansion.

BACKGROUND: Immediate tissue expansion has been reported to expand skin sufficiently to permit primary closure of large facial defects up to 5 cm in diameter. OBJECTIVE: We wished to evaluate and compare skin hooks with foley catheters in producing tissue expansion. METHODS: Seven patients with post-Mohs surgery defects measuring 3.0 to 5.5 cm in diameter and located on scalp, temple, or forehead skin were treated with immediate tissue expansion. RESULTS: Immediate tissue expansion provided a 16 to 36% increase in the tissue available for closure, over and above what was achieved by undermining alone. In each case, adequate stretching of skin was achieved to permit primary closure relatively easily, which was not possible with undermining alone. Skin hooks were found to be equivalent to foley catheters in their ability to produce tissue expansion. At the one year follow-up visit, some spreading of the scar was noted, ranging from 1 to 7 mm, which appears in part to be related to the degree to which the skin was expanded. CONCLUSION: These findings support the concept that immediate tissue expansion is a separate and distinct process from undermining, which provides additional tissue for reconstructive surgery.

Aged↗
PubMed1993

Tissue expansion and Mohs micrographic surgery.

Tissue expansion is of value in the repair of some defects produced by Mohs micrographic surgery. In particular, defects of the nose, forehead, temple and scalp as well as extensive defects in other areas may require expansion. Tissue expansion should be considered prior to Mohs micrographic surgery in these cases. Intraoperative and rapid expansion are useful adjuncts to other repair options. Complications of expansion are frequent and must be anticipated.

Aged↗
PubMed1993

Primary reconstruction of congenital facial lesion defects with tissue expansion.

BACKGROUND: Congenital facial lesions may require surgical intervention to correct deformity or to decrease the potential for malignant degeneration. OBJECTIVE: Hemangiomata and melanocytic and sebaceous nevi are among the most common congenital facial defects. The techniques and outcome of serial tissue expansion in the management of facial lesions were evaluated. METHODS: Seven pediatric patients had congenital facial defects treated with tissue expansion and subsequent excision and reconstruction. RESULTS: All patients had a satisfactory outcome. Complications are reviewed, and in this patient population were minor. CONCLUSIONS: Tissue expansion has a role in surgical management of congenital facial lesions. Staged excision, skin grafting and nonintervention are also options which must be individualized to the case at hand.

Child↗
PubMed2005

Dermatofibrosarcoma protuberans of the forehead and scalp with involvement of the outer calvarial plate: multistaged repair with the use of skin expanders.

BACKGROUND AND OBJECTIVE: Dermatofibrosarcoma protuberans (DFSP) is a locally aggressive and infiltrative tumor that requires Mohs' micrographic surgery or wide excision to treat. Adequate excision often leaves a cosmetic disfiguring defect, particularly if the tumor is located on the head and neck. Complex defects of the face present special problems, such as distortion, ectropion, and retraction of normal tissues. PATIENT AND METHODS: We present a case of an infiltrating DFSP of the forehead and scalp in a young woman. The tumor was removed, and the defect was reconstructed with multistaged repair, which included bone coverage, local and regional flaps, and the use of expanders. RESULTS: A multistaged repair was performed with good clinical outcome and satisfactory cosmetic results. CONCLUSION: Multistaged repair of the face is a viable alternative surgical approach to preserve facial contours and minimize distortion in the treatment of DFSP. This case illustrates the degree of complexity that the treatment of DFSP may involve.

Adult↗
PubMed2004

Breast reconstruction with expanders and implants: a numerical analysis.

In the last few decades, breast reconstruction has evolved significantly due to improvement in surgical techniques and development of new materials. Although most authors consider that breast reconstruction using autologous tissue offers the best aesthetic results, excellent outcomes have been obtained employing silicone implants. However there is a lack of good understanding of the implications of using each type of adjustable implant on tissue dynamics and the influence on final breast shape. The aim of this research is to analyze the stresses and strains that occur in skin immediately after breast reconstruction. This simulation is performed using the finite element package ABAQUS/Explicit.

Breast Implants↗
PubMedDate not supplied

Controlled tissue expansion in the distal extremities of dogs.

Controlled tissue expansion using a 100 cc rectangular silicone elastomer expander was performed in the mid-antebrachium and mid-crus of eight adult mixed-breed dogs. Two expander inflation schedules were followed. Group 1 dogs (n = 4) underwent expander inflation using 10 cc sterile saline every other day, and group 2 dogs (n = 4) underwent expander inflation using 15 cc sterile saline every other day until the nominal volume (100 cc) was attained. Significant mean postexpansion increases in skin surface area of 94.1 cm2 (35.9%) and 108.9 cm2 (37.3%) were measured in the antebrachium and crus, respectively (p < .05). In a second procedure, the expanders were removed and skin flaps were developed from the redundant tissue generated during the expansion process. Single pedicle advancement flaps and transposition flaps were used to cover surgically created defects measuring 5 x 10 cm in the antebrachium and crus. Single pedicle advancement flaps consistently measured 10 x 10 cm and could be advanced to cover defects involving one third of the mid-antebrachial or mid-crural circumference. Transposition flaps were rotated up to 170 degrees and the donor site defects were easily closed under minimal or no tension. Complications included an abscess in one dog and seroma formation in four dogs. Differences in success or complication rates between group 1 dogs and group 2 dogs were not observed; an accelerated inflation schedule using 15 cc sterile saline every other day was recommended.

Abscess↗
PubMedDate not supplied

Rapid tissue expansion for the development of rotational skin flaps in the distal portion of the hindlimb of dogs: an experimental study.

In phase I, tissue expanders were implanted subcutaneously over the lateral crural region of four dogs. The expanders were inflated daily to maintain a constant intraluminal pressure for 7 days. All animals tolerated the pressurized expanders well. Some animal patient discomfort was associated with repeated injections into the subcutaneous filling port. One dog developed a limited area of tissue loss and exposure of the expander. Tissue response to the expanders included epidermal hyperplasia, dermal collagen compression with early fibroplasia, and subcutaneous granulation tissue formation adjacent to the expander pocket. In phase II, a second group of four dogs underwent rapid skin expansion over 7 days. The pressure applied to the expanding skin was determined daily and adjusted to approximate the value reported for capillary pressure in the dog. Tissue discoloration occurred in two dogs, suggestive of impaired circulation. Skin flaps were developed from expanded skin and rotated over the talocrural region. Wound dehiscence occurred along the distal flap margin in three phase II dogs. These wounds healed by second intention. Branches of the caudal saphenous artery were identified, using angiography, as the primary blood supply to the skin flaps.

Animals↗
PubMed2005

Investigation into dosimetric effect of a MAGNA-SITE tissue expander on post-mastectomy radiotherapy.

It is increasingly common for radiotherapy departments to encounter high density objects in patients being planned for radiotherapy. Many cases, such as artificial hip prostheses, are well documented. In our cancer center we have recently come across a new type of implant--a McGhan Style 133 Tissue Expander--implanted in patients who have undergone a mastectomy and will in future have breast reconstruction. This type of implant contains a small rare earth magnet encased in a titanium body, which induces significant perturbations in the dose distribution. These perturbations have been measured using a p-type semiconductor diode. Attenuation of up to 30% of local dose has been observed for a single beam. However, in more realistic clinical situations using tangential parallel opposed beams, it is estimated that part of the planning target volume maybe be underdosed by approximately 10%. Comparisons have been made between measured attenuation and that calculated by a treatment planning system, which demonstrates inadequate modeling of the dose perturbation caused by the implant in this case.

Breast Implants↗
PubMed2006

Injectable self inflating hydrogel pellet expanders for the treatment of orbital volume deficiency in congenital microphthalmos: preliminary results with a new therapeutic approach.

BACKGROUND/AIM: Children with congenital microphthalmos are usually able to wear an eye prosthesis but the cosmetic aspect is determined by the size of the orbital volume deficiency. Instead of using a ball shaped standard hydrogel expander or a regular orbital implant, which would necessitate enucleation of the microphthalmic eye, this study investigates the feasibility of volume augmentation with injectable pellet expanders, as formerly suggested for acquired anophthalmos in adults only. METHOD: The pellet expander is made from a self inflating hydrogel that takes up water by osmosis (dry state: length 8 mm, diameter 2 mm, volume 0.025 ml; in vitro hydrated state after around 1 day: length 15 mm, diameter 4 mm, volume 0.24 ml; swelling capacity: 9.6-fold). This report concerns six patients (two girls and four boys) aged between 4 months and 42 months with unilateral microphthalmos who were treated by injection of 4-14 pellet expanders into the retrobulbar orbital tissue. Volume augmentation was 1-3.5 ml. The pellets were injected using a customised trocar and placed behind the microphthalmos directed into the intraconal space. RESULTS: The increasing orbital volume was noticeable within 2 days and was confirmed by ultrasonography and magnetic resonance imaging. The final result can be anticipated by the volume augmentation effect produced by the amount of saline solution injected in the orbital apex region. All patients were fitted with an artificial eye, which was subsequently enlarged every 3-5 months. Anophthalmic enophthalmos was fully compensated with this technique. No complications have been encountered to date. CONCLUSIONS: Orbital volume augmentation with injectable self inflating hydrogel expander pellets is apparently a safe, quick, and minimally invasive technique for various indications in orbital reconstructive surgery-for example, to treat an enophthalmic appearance in microphthalmos and congenital or acquired anophthalmos.

Child, Preschool↗