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Results for “Tissue Expansion”

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At least 19 recordsLinked to original sources

PubMed1993

[Forum on tissue expansion. Tissue expansion and radiotherapy. Changes in epidermal mitotic index induced by expansion and/or irradiation in the rat].

In order to study the influence of irradiation during skin expansion, an experimental protocol using 15 laboratory rats was undertaken. The present experiment was designed to evaluate the mitotic activity of the epidermis by in vitro autoradiography. The mitotic activity was assessed by the Labelling Index. Experimental data concerning expansion were shown to be consistent with the literature. When a high dose of radiation was delivered to the skin during expansion, a significant increase was observed in the mitotic activity of the epidermis. The range of variation was equivalent to that expected in normal skin. This is the first experimental result in favour of irradiation during skin expansion. However, no conclusion can be drawn concerning the clinical applications (immediate breast reconstruction using tissue expansion) due to the limitations of the present experiment.

Animals↗

PubMed1993

[Forum on tissue expansion. Are tissue expansion and radiotherapy compatible? Apropos of a series of 50 consecutive breast reconstructions].

Tissue expansion has become a method of choice for immediate or delayed breast reconstruction. The compatibility of radiotherapy and tissue expansion is a growing problem. We analyse a series of 50 breast reconstructions by expansion, 24 without radiotherapy and 26 with radiotherapy. For the 24 patients without radiotherapy, very satisfactory cosmetic results were obtained in 71% of cases with 21% of stage III-IV capsular contractures and 8% of failures. For the 26 patients with a history of radiotherapy, very satisfactory cosmetic results were obtained in 65% of cases with 20% of capsular contractures and 10% of failure. 20% of cases also required a myocutaneous flap to complete the reconstruction. The complications related to radiotherapy are due to radiation lesions of endovasculitis and destruction of the network of elastin fibres. They result in the impossibility of filling the expander, deformation of the thoracic cage, expansion without projection, thinning of the tissues over the prosthesis and necrosis and exposure requiring the use of a myocutaneous flap. In conclusion, signs of radiation dermatitis constitute a contraindication to tissue expansion, which is nevertheless possible, but with a higher risk of complications. Irradiation to an expansion prosthesis is associated with an unacceptable complication rate.

Adult↗

PubMed1989

Capsular contracture after breast reconstruction with tissue expansion.

Tissue expansion before placement of an implant for breast reconstruction is said to lessen the chance of capsular contracture. Forty-nine patients who had undergone post-mastectomy breast reconstruction using tissue expansion were reviewed. Capsular contracture was assessed using the Baker scale and compared with the speed of expansion, the degree of over-expansion and the interval between full expansion and placement of the definitive prosthesis. The overall incidence of capsular contracture (Baker III or worse) was 29%. Only one patient, however, has required capsulotomy for capsular contracture alone. Neither the speed of expansion nor the degree of over-expansion influenced the onset of contracture. Those patients with breasts assessed in Baker group I had a significantly longer interval between full expansion and reconstruction than those in Baker group III (p = 0.05). A modification of Baker's scale is suggested for the assessment of reconstructed breasts. Prospective studies are required to define the optimum timing for tissue expansion procedures.

Adult↗

PubMed2002

[Comparison of ultrastructural changes of skin between continuous tissue expansion and conventional tissue expansion].

OBJECTIVE: To observe the ultrastrual changes of the skin between the continuous tissue expansion and the conventional tissue expansion. METHODS: Twelve white piglets were used for this study on an animal model of tissue expansion with the continuous tissue expansion group and the conventional tissue expansion group. The tissue samples in each group were harvested and prepared for the transmission electron microscope observation. RESULTS: The interspace among basal cells and spinose cells was increasing and the numbers of cell conjunctures were decreasing in the both groups. However, these changes in the continuous tissue expansion group were more obvious than in the conventional tissue expansion group. In the dermal layer of the skin, the ultrastructure of collagen fibers were basically normal. But, the fibroblasts and capillary endothelia cells were more activated in the continuous tissue expansion group, compared with the conventional tissue expansion group. The fibroblast apoptosis and collagenolysis spots were observed in both of the groups, while the red blood cells were also found in the tissue leaked outsides from the blood vascular cavities. CONCLUSION: Tissue expansion may result in tissue growth and tissue degeneration in the same time.

Animals↗

PubMedDate not supplied

Tissue expansion.

Tissue expansion has become a popular method of reconstructive surgery over the last few years and is used to reconstruct a wide range of defects. This article aims to outline the technique and results of tissue expansion on the plastic surgery unit in Bradford.

Humans↗

PubMed1992

[Tissue expansion].

Tissue expansion has now achieved an important place in reconstructive surgery, since the first experiments about 10-15 years ago. Expanded tissue used in reconstruction is usually excellently matched for colour, thickness, elasticity and other physical properties. This is particularly important in reconstructions in the head and neck region. Tissue expansion is also used increasingly for breast reconstruction all over the world. It is now the most common procedure for breast reconstruction in USA. Various options using either a temporary or a permanent expander are discussed.

Breast Neoplasms↗

PubMed1990

Basal cell carcinoma: excision with immediate intraoperative tissue expansion.

Tissue expansion in dermatologic surgery has gained wide acceptance. We report the case of a patient with basal cell carcinoma in whom a Foley catheter was used for immediate intraoperative tissue expansion. Wound tension was decreased significantly and primary closure obtained. This technique is appropriate for office surgical procedures and provides an alternative approach to wound closure with flaps and grafts. The Foley catheter is an inexpensive and disposable tissue expander.

Adult↗

PubMed2003

Tissue expansion.

Tissue expansion in the upper extremity is a valuable technique with expanding indications and expected outcomes. The primary indications are coverage problems after trauma, but the technique is also applicable to defects caused by treatment of hemangioma, nevi, tattoos, or hypertrophic scars as well as correction of unstable tissue or as an alternative to free tissue transfer. The advantage of expansion-specifically, match in tissue texture and retention of sensibility-may be more important in the hand and upper extremity than in other areas. The inevitable capsule that forms around the expander does provide a smooth gliding surface for tendons in the forearm and wrist. In conclusion, tissue expansion of the upper extremity offers the surgeon the ability to improve cosmesis in one location without having to sacrifice cosmesis at a second site.

Journal Article↗

PubMed1996

Risk factors for complications in pediatric tissue expansion.

Tissue expansion in children has been associated with complication rates of 20 to 40 percent. A critical analysis of 6 years' (1988-1993) experience with 180 expanders placed in 82 consecutive children was performed to identify those factors which predispose to complications. Major and minor complications each occurred in 9 percent of patients. The factors associated with a statistically significant increase in complications were burns and soft-tissue loss, patient age under 7 years, use of internal expander ports, and a history of two or more prior expansions. In addition, complications were significantly more likely to occur within the first 90 days than during any subsequent expansion. Factors that did not influence complication rate included patient gender, wound drainage upon expander insertion or removal, intraoperative use of antibiotic irrigation, number of expanders placed, use of customized expanders, and operating surgeon.

Adolescent↗

PubMed1985

Advances in tissue expansion.

Tissue expansion offers a versatile new technique in the reconstruction of many areas of the body. The authors discuss laboratory studies that provide insight into the mechanism of the technique and present examples from clinical experience acquired over the past seven years, including applications in breast reconstruction and reconstruction of the scalp, head and neck, and extremities.

Adaptation, Physiological↗

PubMed1987

Burn management: the role of tissue expansion.

Tissue expansion has facilitated reconstruction in selected burn patients. For the past 5 years the authors have used this modality in 45 patients, reconstructing the head and neck, trunk, and extremities.

Breast↗

PubMedDate not supplied

[Tissue expansion of the superior limb].

UNLABELLED: In order to get better results in the treatment of the superior limbs defects we have attempted to take profit of the expansion tissue techniqu. PURPOSE: With the objective of studying the utilization of expansion tissue technique to repair defects in the superior limbs caused by scars or tattoos removal. METHODS: 6 patients with 7 superior limbs defects to be repaired were treated by the technique of tissue expansion with 8 tissue expanders. In 3 patients the lesions were caused by tattoos removal (4 lesions), 2 patients presented lesions caused by burn scars removal nd 1 patient showed lesion caused by removal of a childhood scar. RESULTS: The result of this procedure was excellent in 5 cases and provided total repair of the lesion. However hazards have occurred in one patient who showed a necrosis of the expansion neighbouring area (not a consequence of the expansion) and in other patient the aesthetic result was not satisfactory because he developed a hypertrophic scar. Good aesthetic results were obtained in the other 4 patients. CONCLUSIONS: We have had good results with the utilization of tissue expanders in the superior extremities. The superior limbs have good capacity of expansion and lead to good aesthetic results. Any significant hazards were observed as being a consequence of superior limb tissue expansion.

Arm↗

PubMed1993

Histology and physiology of tissue expansion.

BACKGROUND: Tissue expansion is a concept based on the skin's natural ability to stretch in response to an underlying force. OBJECTIVE: The purpose of this article is to review the histological and physiological changes that occur within the soft tissue and underlying structures during tissue expansion. METHODS: An extensive search of the literature reviewing these changes is summarized herein. RESULTS: Conventional tissue expansion may result in epidermal hypertrophy, decreased dermal, muscle, and adipose thickness, and bone resorption. A vascular capsule and angiogenesis provides a highly vascular flap and improves flap viability. Few soft tissue changes occur during rapid tissue expansion. The ability of the skin to increase in surface area during conventional tissue expansion is primarily because of biological tissue creep. Rapid expansion may result from mechanical tissue creep. CONCLUSION: Many soft tissue changes occur during tissue expansion. Most of these changes return to the pre-expansion state over time following discontinuation of the expansion process.

Animals↗

PubMed2005

Pediatric cervicofacial tissue expansion.

INTRODUCTION: Tissue expanders have long been used for reconstructing large cutaneous and fascio-cutaneous defects in children. Previous studies have examined tissue expansion for all body regions, touching upon the head and neck regions. We present a focused review of our experience with cervicofacial tissue expansion in the pediatric population. MATERIALS AND METHODS: We retrospectively reviewed 89 children who underwent tissue expansion of the head and neck regions at Children's Hospital of Los Angeles. Most patients underwent multiple expander placements bringing the total expander number to 182. Indications for expansion included congenital nevus [N=39], burn scar [N=14], hemangioma/lymphangioma/arteriovenous malformation [N=11], scar due to trauma [N=10], congenital anomaly [N=5], sebaceous nevus [N=3], cutis aplasia [N=2], tumor [N=2], infection [N=2] and scleroderma [N=1]. RESULTS: Of the 182 expanders placed, 56 had an associated complication (30.8%). The most frequent complications included exposure, infection, leakage, migration, flap necrosis, wound separation, and skull bone remodeling. Expanders placed in the neck appeared to have the highest complication rate. CONCLUSIONS: This retrospective review identified a high complication rate in pediatric cervicofacial tissue expansion, which is similar to previously published studies. Despite these findings, tissue expansion in pediatric patients should continue to remain a viable reconstructive option, however, proper patient selection; patient education and informed consent involving a discussion of the expected treatment course and risk profile should be undertaken.

Burns↗

PubMed1993

Osmotically induced tissue expansion with hydrogels: a new dimension in tissue expansion? A preliminary report.

The possibility of using an osmotically-driven system for effective tissue expansion has been verified. As a biocompatible and efficient system, a copolymer of methylmethacrylate and vinylpyrrolidone is used in animal research (rats). This hydrogel was able to generate, in vitro, a physical swelling pressure of approximately 235 mm Hg. The range of possible volume expansion in solutions of differing concentrations was 3 to 30 times its water-free gel form. In animal experiments a high biocompatibility and efficiency in tissue expansion can be observed.

Animals↗

PubMed1988

Tissue expansion.

Controlled tissue expansion began as a concept based on primitive ideas and observations. Its application to breast reconstruction has played a major role in the tissue and psychologic rejuvenation following surgery for breast carcinoma. During the last several years, controlled expansion of tissue has been applied to many other anatomic sites treating many difficult reconstructive and excisional surgeries which heretofore were either impossible or required several stages to accomplish. As experience has grown, the use of tissue expansion has become safer and has been applied to many excisional and reconstructive efforts. The future use of tissue expansion is extremely bright and limited only by the creativity of the surgeon familiar with the technique. In the future, under study is controlled expansion of bone, of nerves, and of other body parts that may prove to be valuable in the surgeon's armamentarium. The dermatologic surgeon should become familiar with the concept and practice of tissue expansion, whether or not it is used in his or her practice. By being familiar with what the reconstructive surgeon can do with tissue expansion, the dermatologist can treat entities perhaps not otherwise treated in the past. For the dermatologist experienced in cutaneous surgery, tissue expansion can be added to his armamentarium in the treatment of male pattern baldness, some local flaps, congenital nevi and larger excisions requiring serial excision in the past as well as tattoos.

Humans↗

PubMed1993

Combined tissue expansion and free tissue transfer for reconstruction of the hand in epidermolysis bullosa-associated malignancy.

The recessive form of dystrophic epidermolysis bullosa (RDEB) is associated with severe hand deformities characterized by cocooning pseudopolysyndactyly, recurrent ulceration, fibrosis, and adduction contracture of the thumb. In addition, RDEB is associated with an aggressive form of squamous carcinoma, notable for rapid metastases, appearance at an early age, and a relative resistance to radiation or chemotherapy. To date, reported reconstructive treatment has been limited to excision with skin grafting or amputation. We report the successful combined use of tissue expansion and microsurgical free tissue transplantation to reconstruct a patient with RDEB found to have malignancy of the hand. Donor skin was found to expand without blistering, and use of the expander allowed primary donor site closure after microsurgical transplantation of a scapular flap. We recommend wide tumor resection and the aggressive use of contemporary reconstructive methods to maintain hand function and associated quality of life in patients with RDEB who develop malignancy.

Adult↗

PubMed1989

Physical, biomechanical, histologic, and biochemical effects of rapid versus conventional tissue expansion.

Clinical tissue expansion has been quite successful but takes 2 to 3 months. This study compares the effects of a conventional tissue expansion regimen of 6 weeks with an accelerated regimen of 2 weeks in the dog model, which is biomechanically similar to the human. In 22 dogs, the skin expanded 34.4 percent in the 2-week and 35.8 percent in the 6-week protocol, excluding stretch and recruitment. There was thinning of the panniculus carnosus in the 6-week group and otherwise no significant decrease in dermal thickness in either group. The biomechanical properties of elasticity and creep did not differ in expanded skin from both groups, while stress/relaxation mildly decreased from a control value of 53.5 percent to 48.8 percent in the 6-week group (p less than 0.05). Collagen activity was increased in both the 6-week and the 2-week groups (p less than 0.001) over nonexpanded skin, and immunohistochemical staining with a monoclonal procollagen antibody demonstrated collagen synthesis by dermal fibroblasts in both groups. We conclude that rapid tissue expansion did not demonstrate any deleterious effects when compared with a conventional regimen.

Animals↗