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Results for “Tissue Expansion”

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At least 595 records · Page 33Linked to original sources

PubMed1994

Growth potential of autogenous cartilage grafts in expanded skin: an experimental study in rabbits.

The effect of tissue expansion on the growth potential of autogenous cartilage grafts was studied in 10-day-old New Zealand white rabbits. The rabbits were divided into two groups: In Group 1 (n = 12) after 2 weeks of tissue expansion by using a 10-ml tissue expander, a cranially based 4 x 4-cm dorsal skin flap was raised and a 1 x 1-cm autogenous cartilage graft from the midportion of the left ear was transplanted beneath the flap in each rabbit. In Group 2 (n = 12) elevation of dorsal skin flaps and transplantation of the grafts were performed in the same way but without a previous tissue expansion. The grafts were removed at 30 and 60 days after transplantation in both groups, for histological examination and measurement of the dimensional changes to determine the growth rate. In both groups, histological examination revealed characteristic findings for cartilage growth, however, Group 1 (expansion) demonstrated a statistically significant increase in the growth of cartilage grafts when compared with Group 2 (control) (p = 0.0001). The results of this study indicate, from the standpoint of acceptance and growth potential of autogenous cartilage framework, that there is no drawback to using this tissue expansion technique for reconstruction of the ear in childhood.

Animals↗

PubMed1996

Interrelations of soft and hard tissues for osseointegrated implants.

Success in using osseointegrated dental implants-optimal function, esthetics, and phonetics-requires selection of the treatment modality that is optimal for the patient, protection of tissue blood supply, and adherence to a plan based on a thorough analysis of all deviations from the normal anatomy. The options for correction of hard-tissue deficiencies are mechanical modification of the implants and reconstructive surgery. Mechanical approaches reduce the time needed for reconstruction but direct the occlusal forces in unnatural directions. Surgical reconstruction is preferable. Any bone graft must be precisely fitted to the recipient site to facilitate revascularization. Restoration of hard-tissue dimensions usually requires soft-tissue coverage and augmentation. There are two basic options: (1) flaps with or without inlay or onlay grafts and (2) controlled tissue expansion. An onlay graft can help restore soft-tissue height and width. Inlay grafts have greater vascularity than onlay grafts, and the color matching is better. Controlled tissue expansion creates "like" tissue without a secondary defect, and fewer tissue transfers are needed. However, the technique is difficult, and the patient must make multiple visits to the office. For implant placement to be successful, the patient's expectations must be understood, and the benefit-to-risk ratio should be extremely high.

Alveolar Bone Loss↗

PubMed1993

The expanded forehead flap for nasal reconstruction.

A 3-year experience using forehead tissue expansion for nasal reconstruction is presented. The series includes 7 expansions in 6 patients with different degrees of nasal loss due to either cancer, trauma, or avascular necrosis. Balloon tissue expansion minimizes the well-known limitations and drawbacks found in using forehead flaps for nasal reconstruction. Technique, timing, and sequencing of procedures are discussed and compared with those of other authors. The complications of tissue expansion are few, but obtaining a satisfactory nasal reconstruction requires multiple operations over a period of time. A learning curve is necessary due to inadequate previous experience and new developments in tissue expanders. The results obtained were possible due to the excellent tissue provided by forehead expansion.

Adult↗

PubMed1992

A comparison of outcomes using three different methods of breast reconstruction.

In a review of 325 postmastectomy breast reconstructions, the aesthetic quality of the result and the risk of unsuccessful outcome were compared for three techniques: tissue expansion (105 breasts), latissimus dorsi myocutaneous flap (47 breasts), and TRAM flap (173 breasts). The aesthetic successes achievable with the three methods were similar, and some excellent results were achieved with each of them. The failure rate after tissue expansion (21 percent) was significantly higher than those observed with the TRAM (3 percent) and latissimus (9 percent) flaps. Tissue expansion also was not as aesthetically successful as other techniques in obese patients. For immediate breast reconstruction, the TRAM flap was the most aesthetically successful technique. Although tissue expansion has advantages and may be the best choice for some patients, methods that used autogenous tissue provided more consistent success.

Abdominal Muscles↗

PubMed1987

Hair replacement techniques. An overview.

From Orentreich's initial studies of the donor and recipient dominance of disease and of dermatologic conditions and his translation of those observations into punch-graft hair transplantation, a number of innovations in hair replacement have occurred. Many of these have been modifications and improvements of punch-graft techniques. Others have had major impacts on the treatment of baldness, such as flaps, scalp reduction, and tissue expansion. It is the combination of techniques, especially tissue expansion and punch-graft transplantation, that seems to hold the greatest promise for surgical treatment of baldness. Whether the hair replacement surgeon performs all of these procedures or not, he or she must be aware of the benefits of all of them and take them into consideration in developing a total plan for the individual patient. The hair transplant surgeon must also be aware that procedures desirable during the earlier stages of baldness may need to be modified with other types of surgery later in life as the alopecia becomes more developed, especially in the face of imprecise genetics in male-pattern baldness. The hair replacement surgeon not only must be aware that such modification may be necessary, but also must be knowledgeable about what those options entail. For example, tissue expansion may be a desirable adjunctive treatment with progression of baldness and would be possible if the parietal area has not been extensively harvested for punch grafts.(ABSTRACT TRUNCATED AT 250 WORDS)

Alopecia↗

PubMed2004

First experience of endoscopic implantation of tissue expanders in plastic and reconstructive surgery.

BACKGROUND: Over the last 15 years, tissue expansion has been used in the treatment of 324 patients at the A. V. Vishnevsky Institute of Surgery. The principal drawbacks of the traditional technique for tissue expansion are the prolonged time needed to complete the process and a high rate of complications. With the traditional technique, the wound created by the implantation of the expander inhibits the expansion of the tissue until healing takes place, which requires 10-14 days. However, attempts to reduce of the length of the incision have been limited by the necessity to ensure good hemostasis in the expander pocket. We describe our initial experience with the endoscopic insertion of tissue expanders. METHODS: We performed the endoscopic implantation of 20 tissue expanders in nine patients. Six patients had postburn scar deformities, one had congenital microtia, one had a capillary malformation, and one had a capillary malformation combined with postburn scar deformity. Tissue expanders were inserted in the head, face, neck, chest wall, scapular, shoulder, forearm, and calf regions. The endoscopic technique was specially adapted according to the features of the different anatomic sites. Endoscopy enabled creation of the expander pocket, with good control of hemostasis, through incisions < or =1 cm. The orientation of these incisions was parallel to forces of tension. Therefore, full expansion began immediately after placement of the expander, without any risk of postoperative wound dehiscence. The expanders were fully inflated intraoperatively accordingly to the principals followed in the traditional technique of implantation for inflation over a 3-week period. Further inflations were carried out regularly either daily or once every other day. RESULTS: The average time required for the tissue expansion was 34 days, which was less than half the time needed with the traditional technique. All flaps remained extant after reconstruction with the expanded tissues. There were no complications. CONCLUSION: The advantages of the endoscopic implantation of tissue expanders are a reduction in expansion time, a shorter hospital stay, less patient discomfort, and the prevention of complications (hematoma, seroma, infection, wound dehiscence).

Adolescent↗

PubMed2004

Alopecia treatment with scalp expansion: some surgical fine points and a simple modification to improve the results.

In the current study, authors present their clinical experience with the esthetic reconstruction of alopecia by means of a tissue expansion technique in 74 consecutive patients who were treated between May 1986 and June 2002 in the Department of Plastic and Reconstructive Surgery. The principles of the conventional technique are mentioned briefly, but the authors essentially tried to explain a number of surgical fine points together with some simple modifications so as to get the maximum profit from the expanded tissue and to decrease the complication rate. In the first 39 patients of this study, who were treated with a conventional tissue expansion technique, the major complication rate was found to be 15.4%. In the last 35 patients, this rate was found to be decreased to 5.7%. The improvement in the major complication rate is attributed to the authors' surgical modifications compared with the conventional technique. The article provides a supplement to the existing literature, underscoring the importance of some surgical fine points and outlining a systematic way of planning expander placement and tissue expansion.

Adolescent↗

PubMed1993

[Value of cutaneous expansion in the repair of skin defects after posterior surgical intervention on the spine].

Tissue expansion spreads widely its field of application through the treatment of large cutaneous defects. Spinal surgery represents a new field for this technique. Iterative and large posterior midline approach can lead to skin necrosis and deep infection which imposes a second look attempt with ablation of orthopaedic devices. Tissue expansion associated with advancement flaps represents a less aggressive choice to treat such post-surgical complications saving regional skin and muscles rather than with conventional flaps. The authors report four cases in which such a technique was applied with long term satisfactory results.

Adult↗

PubMedDate not supplied

Aesthetic results of treatment of large alopecia with total scalp expansion.

In the last 7 years, 18 patients with large alopecia (approximately one-third of hair-bearing scalp) were treated with 31 tissue expansion procedures. In the previous 44 patients, with various degrees of alopecia treated with conventional tissue expansion technique, the major complication rates were as high as reported in the relevant literature. The clinical experience gained with these cases led us to make some modifications in the surgical technique. We applied some simple surgical maneuvers and Z-plasties to the last 18 cases with large alopecia. The major complication rate of 3.2% observed in this study is comparable to the lower complication rates of 6-12% reported in the literature for different degrees of alopecia. We believe that these simple modifications and meticulous approach improve the results of conventional treatment of alopecia with tissue expansion and flap. In this paper, details of the insertion technique and reconstructive procedures and their relevance to the success rate of the aesthetic treatment of the large alopecia are discussed.

Adolescent↗

PubMed1989

Tissue expanders in soft tissue reconstruction.

In order to reconstruct soft tissue defects, plastic and reconstructive surgeons have developed various means that range from the simplest skin grafts to the most complex transfer of microvascular free flaps, but there are no other more than tissue expansion can achieve good results in both aesthetic and functional aspects. From Oct. 1986 to Oct. 1988, tissue expansion was used in seven male and six female patients aged from 11 to 40 years, with a mean of 25. They were divided into 3 groups according to the location of defects: head and neck, 6 cases; trunk, 2 cases; and extremity, 5 cases. Seven cases had successful results and 6 cases failed: one due to infection, one due to leakage of bag and another 4 due to expander extrusion. We know that tissue expansion is a relatively new technique. It expands the healthy tissue immediately adjacent to the defects and provides tissue with near perfect color match, texture, sensation and hair distribution for reconstruction. Although high risk of failure was noted (6 in 13 cases), it still deserves trying for its reasonable aesthetic and functional results.

Adolescent↗

PubMedDate not supplied

Development of the inframammary fold and ptosis in breast reconstruction with textured tissue expanders.

Tissue expansion has become the most important method for postmastectomy breast reconstruction. However, well-defined inframammary fold and ptosis are difficult to achieve with this technique. This study was performed to evaluate the inframammary fold and ptosis achieved in breast reconstruction using a textured tissue expander, later replaced by a textured implant. In ten postmastectomy patients, a textured tissue expander was inserted into a submuscular pocket. Every two to three weeks the volume of the expander was increased by about 30%. About three months after the last filling, the expander was removed and replaced with a permanent textured, gel-filled implant. The profile of the reconstructed breast was recorded before and after the tissue expansion, as well as before and after the change of the implant. The results showed that the inframammary fold did not move significantly upwards or downwards during the expansion period when a textured tissue expander was used. Waiting three months after the last inflation of the expander before replacing it with the permanent implant resulted in a more ptotic breast mound. Usually, however, no real ptosis was achieved, meaning that the angle between the lower part of the breast and the lower chest wall was more than 90 degrees. These findings indicate that a textured expander could help create a pronounced inframammary fold, but without ptosis. A three-month waiting period before inserting the permanent implant may improve the development of an inframammary fold.

Breast↗

PubMedDate not supplied

Aesthetic reconstruction of burn alopecia by using expanded hair-bearing scalp flaps.

Tissue expansion is one of the most important armamentaria for aesthetic scalp reconstruction after burn; however, the proper way to employ this technique for the scalp reconstruction usually presents a challenge to the plastic surgeon, especially in the case of a "sideburn" scenario or a large lesion, as with, for example, hemiscalp alopecia. In this article, 11 patients, with different degrees of hair-bearing scalp loss as a result of burn, and including four patients with hemiscalp alopecia were successfully treated by using tissue expansion. The results show that tissue expansion is a simple, safe, and efficient technique for aesthetic scalp reconstruction. Versatile design of the expanded scalp flap can distribute the expanded hair-bearing scalp properly in the reconstructed recipient site.

Adolescent↗

PubMed1988

Bone graft survival in expanded skin.

The effect of tissue expansion on iliac bone graft (onlay) survival was studied on the skulls of 35 New Zealand white rabbits. Wet bone weights at the time of grafting and at sacrifice in control animals (group I) were compared to three experimental groups. Histologic sections of the developing and resolving pseudosheath and skin envelope were performed. A self-inflating 5-mil-thick silicone expander was used for soft-tissue expansion over the rabbit snout. Bone grafts were subsequently placed in this site. Elliptical snout excision without expansion (group II) demonstrated no statistically significant difference in bone graft survival when compared to controls (group I) (p = 0.350). Full tissue expansion followed by immediate bone grafting (group III) within the pseudosheath cavity likewise demonstrated no statistically significant difference in bone graft survival when compared to controls (group I) (p = 0.500); however, when full tissue expansion was followed by delayed (2 weeks) bone grafting to allow for resolution of the giant cell inflammatory reaction of the pseudosheath (group IV), a statistically significant increased bone graft survival was achieved (p less than 0.001). The study demonstrates that the increased vascularity in the pseudosheath and in the expanded soft-tissue envelope significantly increased bone graft survival only when bone grafting was delayed.

Animals↗

PubMed1994

Experimental expansion of the maxillary sinus.

To assess the feasibility of "tissue" expansion as a means of midface advancement for correction of hypoplasia, expanders were placed in the left maxillary sinuses of New Zealand White rabbits. Twenty-one animals were used for the study, all of whom underwent implantation of radiopaque dental amalgam markers adjacent to cranial sutures at 9 days of age. The nonoperative control group (n = 13) underwent no further surgery. At 30 days of age, the experimental group (n = 8) underwent placement of an inflatable 1-mL Silastic tissue expander in the left maxillary sinus. After 1 week, inflation was begun in serial increments of 0.15-mL normal saline to a total volume of approximately 1.05 mL over a 2-week period. Lateral cephalometrograms were obtained at 9, 30, 60, and 90 days of age to measure growth of the craniofacial skeleton. Both groups demonstrated similar growth between 9 and 30 days of age; however, insertion and inflation of the tissue expander resulted in a statistically significant (p < 0.05) increase in posterior facial height, followed, in 30 days, by a significant increase in the length of the anterior cranial base. The remainder of the cranial base and the cranial vault grew without significant differences between the groups. This study demonstrates that changes in facial morphology can be effected in the growing skeleton through tissue expansion and provides further evidence to support the concept of an interrelated facial skeletal-basicranial-neurocranial axis.

Animals↗

PubMed1996

Skin expansion versus free forearm flap in forehead reconstruction.

The authors present their experience in surgical reconstruction of the forehead cosmetic unit, either with tissue expansion or free tissue transfer. Some of the cases underwent a full reconstruction of the entire cosmetic forehead unit en bloc performed by means of free forearm flap such as in postoncological exeresis and in post-traumatic reconstruction. The other method of choice was tissue expansion. The authors expanded the forehead unit for a giant naevus treatment in a child, and used a bilateral expansion of the forehead for tumour clearance of the middle third of the forehead. Results and problems related to the two techniques are presented and discussed.

Adolescent↗

PubMed1991

Achieving symmetry in the tissue-expanded breast reconstruction.

Breast reconstruction has become such a commonplace procedure over the last ten years that we as plastic surgeons are no longer content to simply create a mound. Today's goal is to create a mound that not only looks like a breast, but also matches the opposite breast. The most commonly used procedures today include simple augmentation if adequate tissue exists, flap reconstruction with either the latissimus dorsi or the tram, and, finally, tissue expansion. Each technique has its own highlights and pitfalls. It is the purpose of this article to deal only with tissue expansion and to present a simple technique to produce symmetry with the opposite breast.

Adult↗

PubMed2004

Other ways to use tissue expanded flaps.

Tissue expansion can arguably be regarded as one of the revolutions in reconstructive plastic surgery. Another three applications (illustrated by three case reports) for tissue expansion are presented.

Burns↗

PubMed1992

Skin expansion as preparation for an opening wedge osteotomy of the mid-foot in arthrogryposis.

A case report is presented in which tissue expansion is used to provide the additional skin needed during an opening wedge mid-foot osteotomy to correct a varus foot deformity in a patient with arthrogryposis multiplex congenita. Tissue expansion is a relatively new method of acquiring coverage for wounds which may have advantages over previous techniques. The risks and drawbacks of this technique will be described in detail.

Arthrogryposis↗