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At least 127 records · Page 7Linked to original sources
PubMed1993

The role of the contractile fibroblast in the capsules around tissue expanders and implants.

The occurrence, structure and contractility of myofibroblasts in the capsules around tissue expanders and static implants has been studied in the rat, pig and humans. The capsules showed a characteristic layered structure with myofibroblasts being the predominant cell type. Capsular strips contract in vitro in a manner characteristic of fibroblast contraction. The contractile ability decreased with the time since expander insertion; and increased with expander exposure, peri-expander infection and clinical evidence of adverse capsular contracture. An hypothesis is proposed that capsular contracture is analogous to wound contraction, and that intraimplant pressure usually inhibits capsular contraction. Evidence is shown from intraexpander pressure measurements to support this hypothesis. The clinical implications for tissue expansion and breast augmentation are discussed.

Animals↗
PubMed1993

A peri-implant capsule flap.

Spherical expanders (30 ml) were implanted under the skin vascularised by the left inferior epigastric pedicle in rats. When expansion was complete, the expander was removed and the animals divided into three groups of 15. In the first group, the floor of the capsule was simply everted. In the second group, a capsule island flap was raised; in the third group, a capsule free flap was raised, transferred to the heterolateral vessels by microanastomosis; the inner side of the various capsule flaps was covered with autologous skin graft. In the three experimental groups, there was complete "take" of the skin grafts in 80% of the animals. Pedicle or free flaps of capsular tissue may be raised and transferred safely in rats.

Animals↗
PubMed1995

Immediate and delayed breast reconstruction with permanent tissue expanders.

Breast reconstruction has greatly advanced during the past decade, offering the surgeon and the patient a choice between autologous tissue transfer and silicone implants, as well as between immediate and delayed reconstruction. In this retrospective study we reviewed the results of immediate versus delayed reconstruction with a permanent tissue expander, a method which is simple, fast and gives good aesthetic results. 19 patients had immediate reconstruction and 25 patients had delayed reconstruction. Capsular contracture (Baker II, III, IV) was more common with delayed (7/25) than immediate (3/19) reconstruction; however, the difference was not statistically significant (p = 0.47). The overall complication rates and the final aesthetic results were similar in the two groups.

Adult↗
PubMed1995

A universal incision for tissue expander insertion.

A new type of V- or W-shaped intralesional incision for tissue expander insertion is presented. The experience with 50 of these incisions in 36 consecutive patients in the period 1990-93 without any complication has proved the safety of this approach and the advantages of V- or W-shaped incisions over tangential or radial incisions.

Adult↗
PubMed1991

Tissue expanders in children.

Tissue expanders are particularly applicable in the pediatric population. They are extremely well tolerated by children and can withstand the everyday play and trauma unique to children. Over the past 2 years, we have used 26 tissue expanders in 17 pediatric patients. Fifteen of the 17 patients successfully underwent reconstructive surgery with the aid of expanders. The expander became exposed in two patients, necessitating removal. In each of these patients, a more complicated and less satisfactory method of reconstruction was performed.

Adolescent↗
PubMed1992

An expandable prosthesis for stabilization of the infant mediastinum following pneumonectomy.

One possible complication in infant pneumonectomy is mediastinal shift that can fatally kink or compress airways and vessels. Rigid prostheses have been used to prevent these problems; however, they cannot be adjusted as the child grows. We report a case of expandable prosthesis implantation in a 24-day-old infant. During the 18 months postimplantation, the prosthesis was periodically injected with a saline/contrast solution to maintain the mediastinum in a midline position as the child grew. At 24-month follow-up the prosthesis was still in place, and midline position of the mediastinum maintained.

Cystic Adenomatoid Malformation of Lung, Congenita↗
PubMed1993

Treatment of giant omphalocele by enlargement of the abdominal cavity with a tissue expander.

Even in the absence of major associated anomalies, treatment of giant omphaloceles is difficult primarily because of the disproportion between the large volume of the omphalocele and the small volume of the intraabdominal cavity. The case of a child is presented in whom conservative treatment had to be abandoned. Reduction of the omphalocele contents and closure of the defect was successfully accomplished after a 19-day period of enlargement of the abdominal cavity by means of an intra-abdominally placed tissue expander.

Abdomen↗
PubMed1993

Use of tissue expanders in final reconstruction of infrapubic midline scar, mons pubis, and vulva after bladder exstrophy repair.

Two patients following bladder exstrophy repair presented for final cosmetic reconstruction with the characteristic lower abdominal midline scar, bisected mons pubis, and laterally displaced labia majora. Tissue expanders were used to obtain additional skin and subcutaneous tissue. After adequate serial expansion, the expanders were removed, scar tissue excised, and primary approximation of healthy tissues performed. A tension-free closure and esthetically pleasing midline incision, mons pubis, and vulva were obtained.

Adolescent↗
PubMed1991

Morphological study of the capsular organization around tissue expanders coated with N-carboxybutyl chitosan.

Expanders coated with N-carboxybutyl chitosan were inserted into surgical wounds in the dorsal skin of rabbits and the formation of capsular tissue was studied by scanning electron microscopy and transmission electron microscopy. N-carboxybutyl chitosan, in the course of the capsular organization, favours and potentiates the correct proliferation and organization of the tissue, rather than sustaining reactive processes leading to scar formation. N-carboxybutyl chitosan stimulates physiologically the tissue repair process and favours angiogenesis, whilst depressing fibrogenesis to a certain extent. Applications are envisaged in the treatment of wounds and in plastic surgery.

Animals↗
PubMed1990

Tissue expansion: past, present, and future.

The history of tissue expansion, technique, indications, and complications are reviewed. A detailed review of delayed tissue expansion's histologic, biochemical, biomechanical, and physiologic changes in the skin is given. There is a net gain in epidermal tissue during delayed expansion. Recent experimental and clinical experience suggests that expansion for 1 to 2 weeks is just as effective as longer delayed expansion for 6 to 8 weeks. A new deviation from standard technique, intraoperative tissue expansion, may have significant implications for dermatologic surgery. Intraoperative tissue expansion is explored in relation to other commonly used techniques of intraoperative load cycling.

Animals↗
PubMed1990

Alveolar ridge augmentation using a new design of inflatable tissue expander: surgical technique and preliminary results.

Ridge augmentation with particulate hydroxyapatite (HA) is compromised by the propensity for the HA particles to disseminate throughout any surgically created space within the tissues. Several techniques designed to overcome this problem have been described, including the use of inflatable tissue expanders. Some of the residual problems related to this technique are attributable to aspects of expander design and surgical technique. This paper which describes a new design of tissue expander which is completely submerged in use, also describes in detail the surgical technique associated with it. Preliminary results are discussed.

Alveolar Process↗
PubMed1989

The use of tissue expanders in the reconstruction of orofacial defects secondary to congenital rubella: case report.

A patient with a severe orofacial defect secondary to congenital rubella is described. The absence of the lower portion of the orbicularis oris muscle, the death of tissue in the infralabial region, as well as the presence of only a vestigial lower lip has hitherto not been reported in the literature. Tissue expanders were used to provide tissue for restoration of the deficient soft tissue of the submental region, a bipedicled flap from the upper lip was used to create a normal anatomic lower lip, and osseointegrated implants were used to stabilize a full denture prosthesis.

Adult↗
PubMed1992

Reconstruction of postburn breast deformities.

Postburn breast deformity is a sequela of severe scar contraction of the burned chest. During the past 3 years, 24 female patients with such deformities required reconstruction, the surgery was performed in our department. These patients, the types of the deformities and the techniques used for reconstruction have been reviewed. For mild deformities (10 patients) reconstructions with skin grafts and local skin flaps were found to be satisfactory. For deformities which affected the mammary development (14 patients), mammary prostheses directly or under the soft tissue obtained by skin expansion or musculocutaneous flaps were used. In three of our patients, reduction mammaplasty or mastopexy was needed to symmetrize the breasts.

Adolescent↗
PubMed1994

Evaluation of soft-tissue properties under controlled expansion for reconstructive surgical use.

The field of tissue surgery using silicone inflatable expanders presently relies on a surgeon's qualitative prediction of the tissue yield during the expansion regime. This work examines the viscoelastic behaviour of pig tissue whilst undergoing expansion and compares the results with classical tensile test methods. Close correlation between the stress relaxation constants for each method is found. The time relaxation of the tissue conforms to a quasi-linear viscoelastic model which enables the time to achieve the maximum viscous tissue yield to be determined. The elastic fraction of tissue has been shown to increase progressively with increasing applied strain whilst the viscous fraction decreases. The greatest tissue yield is generated at low strains and is largely due to the reorientating of the collagen matrix in the direction of the applied stress. This analysis suggests that it may be possible to develop a set of protocols to control and quantify the generation of new tissue during an expansion regime.

Animals↗