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Results for “Tissue Expansion”

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At least 739 records · Page 41Linked to original sources
PubMed1992

Elliptical breast reconstruction: an improved and simplified technique.

An improved and simplified postmastectomy reconstruction by tissue expansion is presented. Utilizing a uniquely designed matched tissue expander and prosthesis, the technique is based on an elliptical concept of breast shape and corresponding volumetric relationships and permits controlled expansion of the lower chest skin. Horizontal and vertical base dimensions and the volume of the contralateral breast are used to determine the size and volume of the appropriate elliptically shaped tissue expander and, subsequently, of the mammary implant. This approach permits surgeons to achieve symmetry more readily by matching the implant to the patient, rather than the patient to the implant.

Equipment Design↗
PubMed1993

Repeated skin expansion for excision of congenital giant nevi in infancy and childhood.

Three children with giant pigmented nevi were treated by repeated tissue expansion. Five flaps were expanded twice, and one flap was expanded three times. The delay between expansions was 4 to 15 months (mean 9 months). With full inflation, vascularization of the flap remained good. However, every new expansion decreased flap length by 50 percent. Overall results with this technique, especially in two infants with giant pigmented nevi involving respectively 20 and 40 percent of the body surface, have been most impressive. Only one major complication has occurred: erosion of the skin caused by a fold of the expander envelope resulting in exposure of the expander. This technique improves the early surgical management of giant pigmented nevi and may provide better long-term functional and cosmetic results.

Abdominal Neoplasms↗
PubMedDate not supplied

Repair of "coup de sabre" with tissue expander.

Two cases of coup de sabre, a linear form of scleroderma, treated by means of tissue expansion, are discussed. Expanded skin flaps on the scalp and forehead provided sufficient skin and tissue for closure of the defect after resection of the defect, and good results were obtained.

Adolescent↗
PubMed1999

The use of tissue expanders in staged abdominal wall reconstruction.

Reconstruction of large abdominal wall defects not amenable to primary closure remains a challenging problem. Various reconstructive techniques have been described in the surgical literature each with its advantages and disadvantages. In this report the authors describe their experience in treating 11 patients with large abdominal wall defects utilizing prosthetic mesh in conjunction with tissue expanders. Between 1986 and 1997 there were 6 pediatric and 5 adult patients treated with this method. The etiology included three congenital omphaloceles, five cases of necrotizing fasciitis, and three gunshot wounds. All patients initially required insertion of prosthetic mesh to bridge their large abdominal wall defects. This was followed by staged abdominal wall reconstruction with tissue expanders and prosthetic mesh. None of the patients had mesh infection or extrusion, and none developed enteric fistula or recurrent hernia. The tissue expansion process was well tolerated by all patients. One patient had partial exposure of the tissue expander due to thinning of the expanded skin. Our results suggest that the use of tissue expanders provides reliable, well-vascularized soft-tissue coverage and minimizes potential mesh-related complications in abdominal wall reconstruction.

Abdominal Muscles↗
PubMed2006

Issues related to choice of breast reconstruction in early-stage breast cancer.

Reconstructive surgeons focus their efforts on refining and developing techniques that optimize oncologic outcome and recreate the most natural breast mound possible. The introduction of perforator flaps offers the potential for faster and more complete recovery, while increasing technical complexity and the risks associated with microsurgical reconstruction. Despite appealing long-lasting results, autologous reconstruction is not the ideal reconstructive choice for every patient. Tissue/expander reconstruction can produce a satisfactory aesthetic outcome and is the reconstruction of choice for most women undergoing breast reconstruction. Immediate autologous reconstruction at the time of mastectomy best resembles the lost breast and favorably withstands radiation, compared with other reconstructive methods. However, the best method for integrating reconstruction and radiation is being actively debated. Placing a tissue expander at the time of mastectomy allows a skin-sparing approach and gives the patient a chance to see how she will feel with an implant. This approach avoids radiation damage to tissue reconstruction flaps, saving them for use later if necessary. This approach, using a tissue expander as a first step, is growing in popularity.

Breast Neoplasms↗
PubMed1995

[Clinical application of expanded thin skin flap].

Fifteen patients were treated with the expanded thin skin flaps with the large area defects of soft tissue resulting from scar, pigmented nevus, hemangioma, chronic ulcer and neurofibroma. The operative procedure includes tissue expansion and defatted flap transplantation. All flaps that preserved only a thickness of 3 mm adipose tissue or superficial fascia beneath the subdermal vascular network survived with the primary healing of 12 cases and the delay healing of 3 cases in the maximal ratio of length to width 4.3:1. The details of clinical experience and primary experiment were presented.

Adolescent↗
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↗
PubMed1997

Reconstruction of scleroderma of the breast.

Although limited to a single case, our study suggests that patients with localized scleroderma of the breast can incur developmental impairment leading to severe breast deformity. The results of any of several methods of breast reconstruction were not available to us for review because of the rarity of this clinical problem. Tissue expansion allowed our patient to avoid the additional scarring and possible functional loss associated with the transfer of autologous tissues. Its successful completion in this one patient indicates that it can be considered for other patients encountered with similar unusual findings.

Adolescent↗
PubMed1993

Periodontal considerations for esthetics: edentulous ridge augmentation.

Edentulous ridge augmentation is a plastic surgical technique that is performed to improve patient esthetics when unsightly, deformed ridges exist. This article describes the etiology of ridge deformities and the many procedures that can be executed to achieve an esthetic, functional result. Historically, soft-tissue mucogingival techniques were described to augment collapsed ridges. Pedicle grafts, free soft-tissue grafts, and subepithelial connective tissue grafts are predictable forms of therapy. More recently, ridge augmentation techniques were developed that regenerate the lost periodontium. These include allografts, bioglasses, guided tissue regenerative procedures, and tissue expansion.

Alveolar Ridge Augmentation↗
PubMed1990

Postphloem, nonvascular transfer in citrus: kinetics, metabolism, and sugar gradients.

Postphloem, nonvascular assimilate transport occurs over an unusually long area in citrus fruit and thus facilitates investigation of this process relative to sugar entry into many sink structures. Labeled photosynthates moving into juice tissues of grapefruit (Citrus paradisi Macf.) slowed dramatically after entering the postphloem transport path (parenchyma cells, narrow portions of segment epidermis, and hair-like, parenchymatous stalks of juice sacs). Kinetic, metabolic, and compositional data indicated that transfer through the nonvascular area was delayed many hours by temporary storage and/or equilibration with sugars in compartments along the postphloem path. Labeled assimilates were generally recovered as sucrose throughout the path, and extent of hexose formation enroute bore no apparent relationship to the assimilate transfer process. Even after 24 hours, radiolabel was restricted to discrete, highly localized areas directly between vascular bundles and juice sacs. Postphloem transfer occurred against an ascending sucrose concentration gradient in young fruit, whereas a descending gradient (favoring diffusion/cytoplasmic streaming) developed only later in maturation. Involvement of a postphloem bulk flow is complicated in the present instance by the extremely limited water loss from juice sacs either via transpiration or fluid backflow. Nonetheless, tissue expansion can account for a collective water inflow of at least 1.0 milliliter per day throughout the majority of juice sac development, thus providing a modest, but potentially important means of nonvascular solution flow. Overall, data indicate postphloem transfer (a) can follow highly localized paths through sizable nonvascular areas (up to 3.0 centimeters total), (b) appears to involve temporary storage and/or equilibration with compartmentalized sugars enroute, (c) can occur either against an overall up-hill sugar gradient (young tissues) or along a descending gradient (near full expansion), and (d) appears to involve at least some contribution by nonvascular mass flow accommodated by tissue expansion.

Journal Article↗
PubMedDate not supplied

[Reconstructive treatment with multiple tissue expanders after an extensive skin burn of the lower extremity].

The paper refers to an experience of skin reconstruction of a widely damaged lower limb as result of a hot water burn injury in a young girl. Evidence is given to adopted reconstruction times, and to the decision not to recur to flap transposition by skin innests, but to the tissue expansion technique, also to avoid new aesthetic damages. The peculiarity of the experience is in the employment of a multiple number of tissues expander, to meet characteristic problems of the limbs related to this reconstructive technique, particularly in presence of heavy burn scars. It is also widely illustrated the operatory phases and times which are necessary to obtain an optimal functional result, with very satisfying aesthetic final appearance.

Adult↗
PubMed1995

Safety of clinical overinflation of tissue expanders.

Despite adherence to a rigorous methodology with precise preexpansion calculations that culminate in the selection of an appropriate implant, the predicted surface area gain after completion of tissue expansion often falls short of the clinical requirements. Rather than then resorting to serial expansions, cutaneous overexpansion usually can be achieved to reach the desired dimensions by overinflation of the implant even well beyond the vendor's stated maximum volume. Over the past decade in a series of 69 patients using 97 tissue expanders, some degree of overexpansion was utilized in 53 implants (54.6 percent). No adverse sequelae due to mechanical failure specifically attributable to this hyperinflation occurred. Complications in the overinflation group (18.9 percent) actually were significantly fewer than those observed in the underexpanded (41.9 percent) (p < 0.03) but were similar in classification. Rather than any inherent superiority in the former group, this observation probably more accurately reflects the fact that overexpansion rarely could be done practically after a significant complication. In any event, the proven safety of limited clinical overexpansion allows a margin of error in the initial choice of implant volume and later permits continued expansion if more tissue than originally anticipated is needed.

Equipment Failure↗
PubMed1991

Xiphoomphaloischiopagus tripus conjoined twins: successful separation following abdominal wall expansion.

A case of xiphoomphaloischiopagus tripus conjoined twins is reported. Particular emphasis was paid to the large abdominal wall defect that would be produced by separation, and the complications resulting from the use of intraperitoneal Silastic tissue expanders are described. As a result of adequate tissue expansion and the use of a vascularized pedicle graft from the fused limb, primary abdominal wall and pelvic closure was possible without complications of wound healing. The consistent finding of a shared lower urinary tract with one ureter from each infant entering each bladder should be anticipated in this type of twinning.

Abdominal Muscles↗
PubMed1990

A new surgical approach to exomphalos.

This report describes the use of tissue expansion for late reconstruction of giant exomphalos. An unexpected advantage was reconstruction of the anterior rectus sheath using the posterior capsule formed by the tissue expanders.

Hernia, Umbilical↗
PubMed1986

Use of the temporary soft-tissue expander in posttraumatic alopecia.

Use of temporary soft-tissue expansion in five patients with posttraumatic alopecia and one patient with congenital alopecia is presented. Indications, operative technique, results, and complications are discussed. It is recommended that transpositional and free scalp flaps be expanded prior to transfer, and it is shown that to achieve greater expansion secondarily, the expanders can be reinserted and the scalp reexpanded as needed. The expansion technique provides a quantity of tissue of similar color, texture, and hair-bearing qualities for reconstruction of adjacent defects and makes secondary reconstruction of donor sites unnecessary. After a minimum follow-up of at least 1 year in each case presented, we have determined that the method is safe, simple, and reliable and provides excellent aesthetic results and high patient acceptance and satisfaction.

Adolescent↗
PubMed2005

Ultrasonic noninvasive temperature estimation using echoshift gradient maps: simulation results.

Percutaneous ultrasound-image-guided radiofrequency (rf) ablation is an effective treatment for patients with hepatic malignancies that are excluded from surgical resection due to other complications. However, ablated regions are not clearly differentiated from normal untreated regions using conventional ultrasound imaging due to similar echogenic tissue properties. In this paper, we investigate the statistics that govern the relationship between temperature elevation and the corresponding temperature map obtained from the gradient of the echoshifts obtained using consecutive ultrasound radiofrequency signals. A relationship derived using experimental data on the sound speed and tissue expansion variations measured on canine liver tissue samples at different elevated temperatures is utilized to generate ultrasound radiofrequency simulated data. The simulated data set is then utilized to statistically estimate the accuracy and precision of the temperature distributions obtained. The results show that temperature increases between 37 and 67 degrees C can be estimated with standard deviations of +/- 3 degrees C. Our results also indicate that the correlation coefficient between consecutive radiofrequency signals should be greater than 0.85 to obtain accurate temperature estimates.

Animals↗
PubMed1995

Effects of subcutaneous expansion on the mechanical properties of porcine skin.

The purpose of this study was to determine the effects of conventional and intraoperative tissue expansion on the biomechanical properties of skin. Two 200-cc silicone tissue expanders were inserted subcutaneously in each of six young pigs. One expander was inflated conventionally (4 weeks) and the other intraoperatively (three times within 1 hr). A skin specimen was excised from each expansion site and each contralateral control site and tested under tension to failure. The sites were closed and allowed to heal for 4 weeks at which time another biopsy specimen was taken from each site. Histological observations and biochemical analyses were conducted. Also, tangent modulus and ultimate stress were determined from the mechanical response of each specimen. Results indicated an initial decrease in stiffness and ultimate strength for conventionally expanded skin. The mechanism for this decrease could not be explained via our current biochemical and histological techniques. Mechanical properties for conventionally expanded skin, after healing, were not significantly different than controls. The mechanical properties for intraoperatively expanded skin were not significantly altered with respect to controls, either at initial expansion or after 4 weeks of healing. The tissue "generated" as a result of intraoperative expansion in the porcine model is likely tissue recruited from the surrounding skin.

Animals↗