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Standard autologous tissue flaps for whole breast reconstruction
Published in Steven J. Kronowitz, John R. Benson, Maurizio B. Nava, Oncoplastic and Reconstructive Management of the Breast, 2020
Steven J. Kronowitz, John R. Benson, Maurizio B. Nava
Patients who have tissue expanders placed under the LD flap usually undergo tissue expansion starting at 2 weeks when the incisions are healed. And in about 3 months, these patients usually have the expanders changed to permanent implants. Other secondary procedures that may be needed include thoracodorsal nerve division, nipple reconstruction, and contralateral procedures for symmetry.
Head and neck
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
Tissue expansion can be used to generate additional skin in difficult or salvage situations when large amounts of unscarred skin are not available. If excessive scarring prevents the use of expansion, then a thin flap such as the TPF may be required, but this will further reduce the shape definition that can be achieved with the cartilage framework.
Life Care Planning for the Burn Patient
Published in Roger O. Weed, Debra E. Berens, Life Care Planning and Case Management Handbook, 2018
Ruth B. Rimmer, Kevin N. Foster
Tissue expansion with scar excision and tissue advancement is another procedure used to improve appearance and function. It has become a major reconstructive modality over the past three decades and increasingly more popular in burn reconstruction. Tissue expansion has many advantages because the existing scarring can be excised and the new expanded skin advanced to cover the wound. The end result is a great match in color and texture. It is a complicated 3 to 4 month process for the patient, but can provide very effective results.
Endoscopy-assisted versus open tissue expander placement in plastic and reconstructive surgery: a meta-analysis
Published in Journal of Plastic Surgery and Hand Surgery, 2023
Chen Dong, Liwei Dong, Zhou Yu, Xianjie Ma
While tissue expansion techniques can generate extra skin and soft tissue of the exact color and texture necessary for reconstruction in a specific area, without the risk of inducing defects or scarring in a donor area [2,8], the lengthy process and the high complication rate are important disadvantages. In previous studies, the complication rate of tissue expansion ranged from 4% to 63% (mean, 17%) [9]. The expansion time of several weeks or months also entails much inconvenience and pain to patients. Traditionally, expanders were placed through an incision made at the edge of the defect. These incisions needed to be of sufficient length to allow unimpeded vision during dissection of the pocket [10]. The large surgical incisions and the delayed injection of expanders often result in longer hospital stay. However, with the introduction of endoscopy, it has become possible to place an expander under direct visualization through a small incision. Many plastic surgeons believe that endoscopic placement of expanders reduces complications and shortens surgery time and the time to full expansion, as well as hospital stay [8,11–16]. However, to date, no evidence-based study has evaluated the benefits of endoscopy-assisted expander placement versus traditional techniques (open expander placement). This meta-analysis aimed to determine whether endoscopy-assisted expander placement can lower the complication rate of tissue expansion and shorten the treatment time.
Effects of Botulinum Toxin A on the Blood Flow in Expanded Rat Skin
Published in Journal of Investigative Surgery, 2022
Hengxin Liu, Zhou Yu, Jiayang Wang, Xi Zhang, Lei Lei, Yu Zhang, Yingjun Su, Xianjie Ma
Skin and soft tissue expansion is widely used in reconstructive surgery for soft tissue defects. It refers to the process of implanting a subcutaneous silicone tissue expander and inflating it gradually by injecting normal saline into the capsule; the mechanical pressure of the expander promotes the regeneration of additional skin with similar texture, color, and structure [1]. However, tissue ischemia and necrosis may occur due to excessive pressure exerted on the blood vessels [2], while decreasing the amount of saline injected into the expander will limit the regeneration of skin expansion. Improving the blood supply of the expanded skin can reduce the probability of tissue ischemia and necrosis and speed up the process of expansion. This will increase the repair radius of the flap, which will make the design of the clinical flap more flexible, which could help make it fit the requirement of the tissue defect better.
Early histological and ultrastructural changes in expanded murine scalp
Published in Ultrastructural Pathology, 2020
Zhou Yu, Shiqiang Liu, Jiangbo Cui, Yajuan Song, Tong Wang, Baoqiang Song, Pai Peng, Xianjie Ma
Tissue expansion has been widely used for plastic, reconstructive, and esthetic surgeries. Using this technique, new tissues are generated by mechanical overstretch.1 To reproduce the process of tissue expansion and explore the mechanism of tissue regeneration, various animal models of human tissue expansion have been established,2 such as the mouse dorsal skin expansion model, which was used in our previous study. The dorsal skin of mice is extremely lax.2–4 Achieving the necessary amount of expansion results in histological changes, which may hamper free ambulation in mice. Nevertheless, the murine scalp is tight, making stretching or movement extremely difficult due to the fixation of ears and eyes. Hence, we hypothesized that expansion of mouse scalp may help overcome the limitations of other dorsally based models where the skin is too lax and may serve as an accurate model of human skin expansion.