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At least 505 records · Page 28Linked to original sources
PubMed2000

Reconstruction of congenital microtia by using a tissue expander.

In the conventional reconstruction of microtia, skin grafting is an absolute necessity because of the scantiness of the skin tissue at the affected site. As the result, color- and texture- matching as well as sensory preservation remain to be improved. To solve these problems, we developed a surgical procedure for reconstruction of microtia by using a tissue expander, which allowed us to reconstruct the erect auricle without the need for skin grafting. In this paper, we introduce and discuss our method using the tissue expander with a review of the literature. We operated on a total of 38 patients with microtia. Most of the patients were around 10 years of age, but 3 were adults. Autogenous cartilage was used, and the helix, antihelix, concha, and tragus were reproduced. Initially, 70 ml custom-made expanders were used; after that, 75 ml or 95 ml ready-made expanders were used. The erect auricle was reconstructed by the primary procedure in 33 patients. The reconstructed auricle was satisfactory in color- and texture-matching and had nearly normal sensation. No major absorption of the cartilage has been noted for 15 years, although a slight retraction of the expanded skin was observed in each patient. In conclusion, microtia repair by using a tissue expander is superior to that by conventional procedures in color- and texture- matching and sensory preservation of the reconstructed auricle.

Adult↗
PubMed2002

[The treatment of ectropion following lower eyelid blepharoplasty with tissue expander in infra-orbital region].

OBJECTIVE: To introduce a new method to correct ectropion following lower eyelid blepharoplasty. METHODS: To expand the skin and tissue in the infra-orbital region of ectropion following lower eyelid blepharoplasty by using an expander (30-50 ml) from oral vestibulum. After 1-2 weeks, the ectropion could be corrected. RESULTS: 32 cases were all successful by using this methods. CONCLUSION: It is a effective method expanding the skin and tissue in infra-orbital region by tissue expander to correct the ectropion following lower eyelid blepharoplasty.

Adult↗
PubMed2002

[Computer-based preoperative planning for breast reconstruction in the woman with unilateral breast hypoplasia].

BACKGROUND: Aim of this paper is to describe a computer program which can provide objective and quantitative data useful for the selection of the proper implant in order to obtain the symmetry with the contralateral breast in case of unilateral breast reconstruction by tissue expansion, especially for the surgeon without experience or for the occasional operator. METHODS: Our C++ program provides the final implant volume using the measurements of the semi-circumference and projection of the contralateral breast performed on the supine patient. The aim is the symmetry of the two breasts. RESULTS: According to our experience in breast reconstruction by tissue expanders, this program allows non invasive and simple measurements of the breast volume, useful to obtain the mammary symmetry. CONCLUSIONS: In case of breast reconstruction by tissue expansion, the preoperative evaluation is usually based on the surgeon's experience and on empirical observations without knowing the correct volume to reach. For this reason our program is useful to know the necessary volume for breast reconstruction, and therefore it allows the surgeon to obtain a better plastic result.

Adult↗
PubMed2002

[The influence of over-expansion on the blood supply of an axial-pattern flap].

OBJECTIVE: To investigate the influence of over-expansion on the viability and vascularity of an axial-pattern flap. METHODS: Tissue expanders were implanted subcutaneously on the buttock of the mini-pig. After over expansion, an axial-pattern over-expanded skin flap was elevated in the pig of the experimental group. The differences in flap survival, LDF, MDA content and fluorescein stain were observed between the control and the experimental groups. The vascular architecture changes were also recorded using histological and clearing specimen examination. RESULTS: The microcirculation in the distal segment of the axial flap was significantly weakened after over-expansion. There were injury manifestation, change in vessel distribution and reduction of vascular territory in the axial over-expanded flap. CONCLUSIONS: Over-expansion could cause chronic injuries to the axial vessel network and damage the blood supply of the axial-pattern flap.

Animals↗
PubMed2002

[The influence of expansion maintenance period upon in vivo skin tension and immediate stretch-back rate of the expanded skin].

OBJECTIVE: The study was to investigate the influence of maintenance period of expansion upon skin tension and immediate stretch-back rate of the expanded skin. METHODS: 30 expanders (240 ml) were implanted in six adult dogs, which were divided into four groups: group A with 2-week saline injection of the expander; group B with 6-week injection; group C with sham-operation and group D as the blank control group. The first two groups were subdivided into three groups respectively according to different maintaining times of one week, two weeks and four weeks. When full inflation was finished, a 4 cm x 7 cm expanded flap was created and in vivo skin tension and stretch-back ratio of the flap were measured. The Comparison was made in terms of in vivo skin tension and immediate stretch-back ratio between different injection and different maintenance periods. RESULTS: With expansion maintenance time increasing, the in vivo skin tension and immediate stretch-back ratio decreased. After the capsule of the expand skin flap was removed, the in vivo skin tension and immediate stretch-back rate significantly reduced. Based on the experimental results, 16 patients were treated with implantation of 23 expanders. Their average expander injection time was 14 days and the average maintenance time was 25 days. All expanders obtained good results except one extrusion. CONCLUSION: In skin and soft tissue expansion, in vivo skin tension and immediate stretch-back ratio can be reduced through prolonged maintenance of expansion and capsule removal from the expanded skin flap.

Adolescent↗
PubMed2002

[Computer-aided tissue expansion 3D profilometry and surgery planning system].

OBJECTIVE: To develop and evaluate the computer-aided system in measurement of expanded skin and preoperative planning. METHODS: Stereophotogrammetric technique was used to gain the 3D image-pairs, from which the contours of the expanded sites were restored. The 3D surface data were provided to the specially developed "computer-aided tissue expansion 3D profilometry and surgery planning system", to calculate the expansion area and help the preoperative design. RESULTS: The system has been applied clinically in 16 tissue expansion sites of 11 patients with fairly good results since March 1999. Compared with the traditional method, this system is accurate, repeatable and feasible. CONCLUSION: This technique is useful and promising for improving the operation of tissue expansion.

Adult↗
PubMed2003

Immediate breast reconstruction-impact on radiation management.

Breast reconstruction is an option for women undergoing modified radical mastectomy due to a diagnosis of breast cancer. In certain patients, breast reconstruction is performed by insertion of a temporary tissue expander prior to the placement of permanent breast implants. Some of these patients, following mastectomy, may require chest wall irradiation to prevent loco regional relapse. The compatibility of radiation and tissue expanders placed in the chest wall is of major concern to the radiation oncologist. Clinically undetectable changes can occur in the tissue expander during the course of radiation therapy. This can lead to radiation treatment set-up changes, variation in tissue expansion resulting in unwanted cosmesis, and deviation from the prescribed radiation dose leading to over and/or under dosing of tumor burden. At Howard University hospital, a CT scan was utilized to evaluate the status of the temporary tissue expander during radiation treatment to enable us to prevent radiation treatment related complications resulting from dosimetric discrepancies. CT images of the tissue expander were obtained through the course of treatment. To avoid a 'geographic miss' the amount of fluid injected into the tissue expander was kept constant following patient's satisfaction with the size of the breast mound. The CT scans allowed better visualization of the prosthesis and its relation to the surrounding tumor bed. This technique ensured that anatomical changes occurring during radiation treatment, if any, were minimized. Repeated dosimetry evaluations showed no changes to the prescribed dose distribution. A CT of the reconstructed breast provides an important quality control. Further studies with greater number of patients are required for confirming this impact on radiation treatment.

Breast Implants↗
PubMed2003

[Labia minora skin flap vaginoplasty using tissue expansion].

OBJECTIVE: This is to introduce a method for vagina reconstruction using the expanded labia minora flap. METHODS: Two tissue expanders were implanted in the labia minora bilaterally and expanded slowly over 4 weeks. In the operation, the expanded labial tissue was advanced as a bipedicle flap to line the reconstructed vagina. Five patients were treated with this method. Postoperative stent placement and dilation resulted in a vaginal canal exceeding 8 cm in depth. RESULTS: During the follow-up of 6 months to 2 years, four of the five patients got married. The vulva exhibited almost indistinguishable appearance. The reconstructed vagina had sensory and secretary functions. Its morphology and depth well meet the physiological demand. CONCLUSIONS: The modified method of tissue expansion vaginoplasty using the labia minora bipedicle flap is a good option for vagina surgery. The reconstructed vagina possesses the anatomical and physiological resemblance.

Female↗
PubMed2003

[Local application of bFGF and sucralfate during continuous tissue expansion].

OBJECTIVE: To investigate the effect of local application of bFGF and sucralfate during continuous tissue expansion (CTE). METHODS: CTE combined with local administration of bFGF and sucralfate was used in twelve patients with scar and nasal tip defects. Twenty three expanders were placed in the subcutaneous pockets through intralesion short incisions. Continuous expansion began at 1-3 days after expander implantation. The histomorphological changes and epidermal cell proliferation were observed. The clinical results were investigated. RESULTS: The average inflation time was 8.9 days. The average interval of the two operations was 13.5 days. The average hospitalization was 28.4 days. The average immediate stretch-back rate of the expanded skin was 25.7%. The clinical results were satisfactory without any complications. Histological examinations showed that the epidermal, granular and spinous layer became thicker. The basal cells increased significantly. The dermis thinned slightly and the collagen fibers became thicker. The elastic fiber regenerated significantly. Fibroblast and capillary density increased obviously. The immunohistochemistry analysis showed that the proliferation of epidemic basal cells was significant postoperatively. CONCLUSION: Local application of exogenous bFGF and sucralfate during CTE was feasible in patients. It could accelerate tissue expansion and improve the quality of expanded skin flap.

Capillaries↗
PubMed2003

[The effect of bFGF and sucralfate on cell proliferation during continuous tissue expansion].

OBJECTIVE: To investigate the effect of local application of bFGF combined with sucralfate on the cell proliferation during continuous tissue expansion (CTE). METHODS: Nine white pigs were selected to undergo the continuous tissue expansion in this study and treated with bFGF and sucralfate, respectively as the following groups: group 1 with both bFGF and sucralfate, group 2 only with bFGF, group 3 with only sucralfate, and group 4 with saline as control. Fifteen samples were taken in each pig for immunohistochemistry analysis 1-14 days and 6 weeks after the operation. RESULTS: In the group with both bFGF and sucralfate, the epidermic basal cells proliferated significantly after the operation and reached top level in 3 days, which was statistical higher than the control group, but the multiplication of basal cell was the lowest 14 days after the operation, still more than the control group. In dermal layer, proliferation of fibroblasts, vessel endothelial cells, hair follicles epidermic cells and sweat gland epicytes was also significant higher in the group with both bFGF and sucralfate than that the control group and reached top level 7 day after the operation, but the proliferation of cells decreased obviously 14 days after the operation, still higher than the control group. The mitotic activity of cells returned to the basal level in 42 days. There were no significant differences among the group 2, group 3 and group 4. CONCLUSION: Local application of both bFGF and sucralfate could be more effect to induce cells multiplication during early skin expansion to facilitate the growth of neoformed skin soft tissue.

Animals↗
PubMed1992

Quantitative analysis of lidocaine hydrochloride delivery by diffusion across tissue expander membranes.

Permeability of Silastic tissue expander shells to lidocaine was studied to investigate the feasibility of intraluminal lidocaine injection for pain relief during soft-tissue expansion. Both intact expanders and an apparatus using isolated Silastic membrane segments were used to partition solutions of various lidocaine concentrations, and the rate of diffusion was quantitatively measured using a fluorescence polarization immunoassay. Lidocaine flux was found to follow Fick's law of passive diffusion with respect to time, surface area, and concentration gradient for the first 9 hours, with a permeability coefficient of 10.3 +/- 2.6 micrograms (h.cm2.percent)-1 (mean +/- SD) and diffusion coefficient of 7.5 x 10(-7) cm2/min for an average membrane thickness of 473 +/- 23 microns. After 9 hours, the lidocaine flux decreased exponentially, although the concentration gradient across the membrane remained essentially the same order of magnitude. Plasma proteins in the outer bathing solution and methylparaben used as a preservative in the standard lidocaine formulation had no influence on the change in transport flux with time. At the end of the linear portion of the diffusion curve, less than 2 percent of the total intraluminal lidocaine had crossed the membrane. Potential toxicity in the event of implant rupture limits the maximum total lidocaine dose to approximately 500 mg within an expander at any one time. Within these limits, the capacity for lidocaine delivery of 500 mg lidocaine by a 640-cc tissue expander would be only 6 mg during the first 9 hours after administration.(ABSTRACT TRUNCATED AT 250 WORDS)

Diffusion↗
PubMed1992

Small bowel protection with "STEP". Silastic tissue expander prosthesis.

This is a case report of a patient presenting with rectal carcinoma and Crohn's disease. Adjuvant treatment was considered to be mandatory on the basis of local extension. Therefore a Silastic Tissue Expander Prosthesis (STEP), connected with a subcutaneously located self-sealing valve system, was introduced surgically to push small bowel up out of the treatment portals. Patient received 55 Gy without any acute or late complication. This easy technique allows radiotherapy in conditions where complete elimination of small bowel outside the treatment volume is required.

Adenocarcinoma↗
PubMed1992

[Experience with the use of Soviet interstitial expanders for eliminating soft-tissue defects in the head and neck area].

Extension of the skin with the help of an interstitial expander allows to rationally use local tissues. Soviet models of tissue expanders of different designs were developed and approved in clinic. 46 operations were performed on 23 patients. Effective results of using the expanders were obtained during repairing extensive defects of the hairy part of the head.

Adult↗