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Results for “Tissue Expansion Devices”

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At least 19 recordsLinked to original sources

PubMed1989

High- and low-technology solutions for massive cavernous hemangioma of the face: lasers and leeches to the rescue.

A massive cavernous hemangioma of the face has been resected using a combination of old and new techniques. The ability of the neodymium: YAG laser to cut with excellent hemostasis formed the basis for the resection. Adjuncts to the surgical excision included such high-technology modalities as laser Doppler flowmeters and tissue expanders. Flap viability was salvaged by the lowly but essential common leech. This case is presented to illustrate the fantastic array of modalities available to plastic surgeons for major resections and reconstructions.

Adult↗

PubMed1992

Continuous versus intraoperative expansion in the pig model.

Continuous tissue expansion utilizing a continuous infusion device that maintains a constant expander pressure was previously demonstrated to be feasible and successful in obtaining rapid tissue expansion in a canine model. Intraoperative tissue expansion has been described and has gained some clinical acceptance as a method to gain rapid expansion. We compared the efficacy of continuous tissue expansion versus intraoperative tissue expansion in a piglet model. After completing a pilot study, continuous tissue expansion was performed in six pigs (14.5 to 20 kg) on one flank over a 3-day period utilizing an improved prototype device; at the termination of continuous tissue expansion, intraoperative tissue expansion was performed on the opposite flank. There were no complications or continuous tissue expansion device malfunctions. Intraoperative tissue expansion gave a true gain in area of 7.4 percent, while continuous tissue expansion produced a 22 percent gain (p < 0.02). When the effects of both recruitment and expansion were added, continuous tissue expansion gave a dividend of 286 percent versus 192 percent for intraoperative tissue expansion (p < 0.01). Biomechanically, intraoperative tissue expansion skin showed few differences from unexpanded skin, while continuous tissue expansion skin showed a significant increase in stress relaxation (47.78 versus 38.74) and decrease in breaking strength. Histologic analysis revealed some epidermal hyperplasia and inflammation surrounding the continuous tissue expansion expander and some vascular congestion over the intraoperative tissue expansion expander. We conclude that continuous tissue expansion is superior to intraoperative tissue expansion and that the prototype device may be useful clinically.

Animals↗

PubMed1990

The use of a prosthetic tissue expander to displace bowel from a brachytherapy implant site.

We describe the use of a prosthetic maneuver to displace bowel from an implant site. The patient presented with a recurrent low grade fibrosarcoma which was grossly excised with positive microscopic margins in the right paravertebral area. For this reason we performed an Iridium-192 implant using afterloading catheters. Because of several dense adhesions, it was not possible to mobilize an omental sling over the implant site. To prevent the small bowel from lying on the catheters, we inserted a prosthetic breast tissue expander. This was expanded with saline and bacitracin solution and placed in the tumor bed overlying the catheters, thereby displacing the small bowel away from the sources. A postoperative CT scan with gastrograffin demonstrated that this procedure was effective. There were no complications. We conclude that such devices are suitable for use under these circumstances and can achieve the objective of decreasing the dose of radiation to the small bowel.

Abdominal Neoplasms↗

PubMed1991

Preoperative non-surgical over-correction of cleft lip nasal deformity.

Alar cartilage, which is elastic like auricular cartilage, is correctable in the early neonatal period. Taking advantage of this correctability, we have performed preoperative non-surgical over-correction for cleft lip nasal deformity of incomplete and complete cleft lips with a Simonart's band. The device for this correction was made by processing a nostril retainer into a nostril over-corrector which utilises a spring of silicone rubber, works like a tissue expander and is supported by the nostril floor. Twenty cases are reviewed whose follow-up lasted more than 19 months. The earlier the non-surgical over-correction began, the more satisfactory were the results that were obtained.

Cleft Lip↗

PubMed1992

Subclinical infection of the silicone breast implant surface as a possible cause of capsular contracture.

In order to reexamine the possible association between bacterial presence and capsular contracture, 55 silicone devices (mammary implants or tissue expanders) were cultured at the time of their removal from 40 patients. Special culture techniques were used in an attempt to recover bacteria adhering to the smooth-surfaced implant and encased in glycocalyx biofilm. Bacteria were detected on 56% (15 of 27) of implants surrounded by contracted capsules and on 18% (5 of 28) of those without capsular contracture (p less than 0.05). Only three implants tested positive using routine plating techniques. The predominant isolate was Staphylococcus epidermidis. The concept that capsular contracture is associated with subclinical infection of silicone implants is supported by this study. With changes in the microbiological technique, bacterial recovery and growth occurs at a frequency greater than previously thought.

Adult↗

PubMed1990

Facial reconstruction for radiation-induced skin cancer.

Radiation-induced skin cancers can be difficult to diagnose and treat. Typically, a patient who has received orthovoltage radiotherapy for disorders such as acne, eczema, tinea capitis, skin tuberculosis, and skin cancer can expect that aggressive skin cancers and chronic radiodermatitis may develop subsequently. Cryptic facial cancers can lead to metastases and death. Prophylactic widefield excision of previously irradiated facial skin that has been subject to multiple recurrent skin cancers is suggested as a method of deterring future cutaneous malignancy and metastases. The use of tissue expanders and full-thickness skin grafts offers an expedient and successful method of subsequent reconstruction.

Acne Vulgaris↗

PubMed1990

Tissue expansion of the head and neck. Indications, technique, and complications.

Tissue expansion is indicated in the reconstruction of various defects of the head and neck in instances where there is inadequate adjacent tissue to allow either primary closure of the defect or repair with a local flap. It may also be indicated in instances where repair of a defect by an alternative method such as a local, regional, or distant flap will result in an unacceptable donor or recipient site deformity. Although tissue expansion is simplistic in concept, it does require judgment and indepth preoperative planning to ensure optimal results. The complication rate is high for tissue expansion in the head and neck, particularly in the cheek and neck area. Despite the frequency of complications, in the vast majority of cases the intended reconstruction is successful.

Dermatologic Surgical Procedures↗

PubMed1990

Rapid intraoperative tissue expansion in reconstruction of the head and neck.

A prolonged tissue expansion has the advantage of creating large amounts of additional skin for reconstructing cutaneous defects that might not be possible without the use of multiple, regional, distant, or microsurgical flaps. In spite of this, there are disadvantages, many of which can be circumvented by the use of rapid intraoperative tissue expansion instead. Although rapid expansion does not increase skin surface area as much as prolonged expansion, it may be helpful in assisting with closure of defects that might otherwise be problematic.

Face↗

PubMed1991

Rapid intraoperative tissue expansion for closure of facial defects.

Rapid intraoperative tissue expansion (RITE) has been shown to have definite applicability to reconstruction in the head and neck. However, widespread use of this modality has yet to be adopted by the otolaryngologic community. Believing that RITE might offer some advantages in the reconstruction of soft-tissue facial defects following Mohs micrographic surgery for cutaneous malignant neoplasms, we evaluated 30 consecutive patients referred for cosmetic reconstruction after Mohs micrographic surgery for the use of RITE. Eight patients were selected and underwent reconstruction using a total of 10 tissue expanders. Herein, we describe our experience with this initial series as well as some background and future applications of RITE.

Adult↗

PubMed1992

Versatile use of skin expanders in facial plastic surgery.

Large soft-tissue resection defects of the face and scalp present an arduous technical problem for the facial plastic surgeon. Successfully matching tissue coverage with similar skin color and texture is usually limited by the amount of available local skin. Also, the need to limit distortion of fixed anatomic sites when harvesting local skin must be addressed. With the advent and utilization of soft-tissue expanders, the availability of local skin is increased and anatomic distortions are limited. This article describes the versatile use of skin expansion in facial plastic and reconstructive surgery. Expansion techniques include long-term expansion for scalp and cervicofacial defects. Acute intraoperative expansion techniques address repair of perioral, labial, and nasal mucosal lining defects. The success, limitations, and complications of these techniques are reviewed.

Adolescent↗

PubMed1990

The creation of a small bowel pouch by tissue expansion--an experimental study in pigs.

Tissue expanders (inflatable silicone balloons) were implanted into a bypassed ileum segment of seven pigs and consecutively filled over 8 to 12 weeks. The mean increase of the volume of the small bowel loops was 12 fold with a maximum of 22.8 times the original volume. The final volume 9 weeks after expander removal still presented an increase of 500%. Histologically there was an increase of the thickness of all layers of the bowel wall, especially in the tunica muscularis. The mucosa showed a value above normal in mean in vitro 14C-resorption capacity per surface area in the reintegrated bowel. Possible clinical applications of the augmentation of the gut by expansion as a rectum substitute after proctocolectomy, as a urinary bladder or stomach substitute, and for the treatment of short bowel syndrome are discussed.

Animals↗

PubMed1989

Aesthetic surgery for microtia.

We describe here a technique for reconstruction of the external ear based upon an autogenous costal cartilage graft which is inserted into a cutaneous pocket dissected in the auricular area. Three subsequent procedures are then performed: rotation of the ear-lobe; reconstruction of the tragus; and elevation of the auricle. The ideal age for reconstruction is about 7 years. This technique was originally described by Brent, who has a very extensive experience with this kind of surgery. Skin deficiencies can be overcome by using either a temporo-parietal fascial flap or a skin expander.

Cartilage↗

PubMedDate not supplied

Breast reconstruction: progress in the past decade.

There have been numerous advances in breast reconstruction techniques of the past decade. The disappearance of the radical mastectomy along with the increased frequency of smaller tumor detection have contributed significantly to these changes. Furthermore, reliable studies have shown that breast reconstruction does not interfere with extirpative surgery or delay postoperative adjuvant therapy if indicated. Studies such as these have led increasing numbers of women to elect immediate breast reconstruction as opposed to delaying that reconstruction for months or even years after the tumor extirpation. The advent of successful breast reconstruction using autogenous tissue provided the most radical change to reconstructive techniques over the past 10 years. The TRAM (transverse rectus abdominis myocutaneous) flap was the first of these techniques to be introduced and has rapidly assumed a position of prominence among those techniques chosen for breast reconstruction. The LTTF (lateral transverse thigh flap) and the buttock flap, while requiring microsurgical technique, are important alternatives for those patients who choose autogenous tissue breast reconstruction and should be presented to women during the discussion of alternatives for breast reconstruction. Implant technology has continued to improve with the introduction of the tissue expander, the most important addition in the past decade. Investigations are currently underway to provide a long-term tissue expander that does not have to be removed and replaced by a permanent implant. The ultimate end result would be to create a more normal breast shape without firmness. And the use of stacked or directional expanders may allow more freedom in creation of the new breast shape to conform to the opposite side. Finally, nipple areola reconstruction has improved significantly as the tissues of the breast mound itself are used for the new nipple and areola, thereby avoiding the transfer of grafts from distant sites which do not generally maintain their size or projection over time.

Adult↗

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↗

PubMed1991

Presuturing in rhytidectomy: a case report.

The use of intraoperative tissue expanders or staged skin excision to improve the results of facelift surgery has been previously reported. However, it is debatable whether excess skin excision improves the final result of rhytidectomy. To determine whether increased skin excision without increased skin tension on the suture line could improve the final results of facelift surgery, a unilateral presuturing technique was used on one patient. Equal bilateral skin tension at the suture line, checked with a spring dynamometer, resulted in a marked increase in the amount of skin excised on the presutured side. No significant difference was noted initially after the operation, but the results at six weeks and at one year after surgery were felt by both patient and physician to be slightly better on the presutured side.

Aged↗

PubMed1991

A special tissue expander in combination with extensive scalp-lifting.

Although posterior closure of male pattern baldness is usually accomplished in two procedures when using extensive scalp-lifting, there is the occasional patient who will require three operations because of very poor scalp laxity. A newly developed horseshoe-shaped tissue expander was designed for these patients so that a third procedure could be eliminated. This differential expander is actually placed during the first extensive scalp-lifting operation. This differs from the conventional placement as a separate preliminary operation. The significant salient features of this expander and the technique of placement are discussed in detail.

Alopecia↗

PubMed1990

Right pneumonectomy syndrome in infancy treated with an expandable prosthesis.

Severe respiratory distress developed in a 5-month-old infant approximately ten days after pneumonectomy for complete sequestration of the right lung. Right pneumonectomy syndrome was diagnosed by bronchography, which revealed thinning and obstruction of the left main bronchus during expiration. A right thoracotomy was then performed, and an inflatable tissue expander with a subcutaneous injection port was inserted into the right chest cavity to prevent recurrence of the mediastinal shift and to allow for future growth. The patient has done well, requiring reinjection of the prosthesis with additional volume on one occasion in a 20-month period of follow-up.

Airway Obstruction↗

PubMed1990

The use of tissue expanders in immediate breast reconstruction following mastectomy for cancer.

From April 1985 to March 1987, 50 women had 56 mastectomies for documented cancer. A tissue expander was used for immediate reconstruction in each case. The patient records were used to determine morbidity and mortality, as well as to examine the effect of reconstruction on adjuvant therapy, cancer surveillance, adequacy of cancer surgery and patient satisfaction. The patients were followed up for an average of 13 months. Fifty-two of 56 expanders were successfully replaced with a permanent prosthesis. Forty-seven women remain alive. Local or regional recurrence did not occur in any women within the study period. Complications, of which superficial skin necrosis was most common, occurred in 35% of reconstructions and were investigated critically. Patient satisfaction was high. Dissatisfaction was not related to the incidence of complications but rather appeared to reflect the success of the patient's cancer treatment.

Adult↗