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A single center experience of craniofacial tissue expansion and reconstruction.

Balaji SM - Ann Maxillofac Surg (2015 Jan-Jun)

Bottom Line: Descriptive statistics, Kruskal-Wallis and Mann-Whitney tests were applied as required and a P ≤ 0.05 was taken as significant.Trauma contributed to greater number of defects (57.1%).Owing to ease of access and better results, more expanders have been placed in cheek (50%), followed by neck (33.33%).

View Article: PubMed Central - PubMed

Affiliation: Director and Consultant Maxillofacial Surgeon, Balaji Dental and Craniofacial Hospital, Teynampet, Chennai, Tamil Nadu, India.

ABSTRACT

Introduction: Tissue expansion is a versatile technique for craniofacial soft tissue defects. It has been extremely useful to restore the form and function along with good esthetics that were otherwise unobtainable.

Objectives: To review the use of tissue expansion in the craniofacial region, with particular emphasis on indication, site, days, volume of the defect and tissue expansion used along with complications.

Materials and methods: Retrospective review of data on 18 expanded flap reconstructions performed in 14 patients during the period 2008-2013. Tissue expanders were placed on a subcutaneous plane above the fascia and inflated weekly. The expanded skin was used as a transposition flap for the reconstruction. Data were collected from archival records and tabulated in SPSS. Descriptive statistics, Kruskal-Wallis and Mann-Whitney tests were applied as required and a P ≤ 0.05 was taken as significant.

Results: Trauma contributed to greater number of defects (57.1%). The most common defect occurs in face/cheek compartment (57.15%) followed by nose (35.71%). Owing to ease of access and better results, more expanders have been placed in cheek (50%), followed by neck (33.33%). The mean defect size was 2983.58 ± 828.27 mm(2), required 32.14 ± 6.31 days, 335.6 ± 156.51 ml in 5.29 ± 1.5 cycles of tissue expansion. The mean rate of expansion was 59.17 ± 16.27, 69.11 ± 30.19 and 62.6 ± 25.75 for forehead, face/cheek and neck cases respectively (P = 0.873).

Discussion: Laxity of skin appears to be a good indicator of the rate of the expansion. The most favorable site for tissue expansion is cheek followed by neck. The study also shows that tissue expansion is an efficient and valuable technique for reconstruction of large craniofacial skin defects.

No MeSH data available.


Related in: MedlinePlus

(a-c) Deformity in forehead region during inflation due to poor skin laxity leading to failure. Device drained, deflated removed and site sutured
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Figure 15: (a-c) Deformity in forehead region during inflation due to poor skin laxity leading to failure. Device drained, deflated removed and site sutured

Mentions: The goal of tissue expansion is to create adequate amount of local tissue that matches in color and texture, which would give esthetically pleasing results. In addition, the advancement of local flap ensure adequate blood supply to the region, ensuring proper healing and success of the expanded flap. Owing to expansion, donor site morbidity can also be minimized to a greater extent. Since the time of its inception and advocacy, the technique has not been free from disadvantages [Figures 11–14]. It was a highly sensitive technique and rate of complications were large. Advantages of tissue expansion are (i) No deforming secondary defects; (ii) No distant flaps; (iii) Best color match, texture, hair bearing; (iv) Better vascularity; (v) best survival of the reconstruction. The disadvantages or discomfort include: (i) Frequent office visits for inflation or prolonged stay; (ii) discomfort and; (iii) Deformity during inflation.[1]


A single center experience of craniofacial tissue expansion and reconstruction.

Balaji SM - Ann Maxillofac Surg (2015 Jan-Jun)

(a-c) Deformity in forehead region during inflation due to poor skin laxity leading to failure. Device drained, deflated removed and site sutured
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4555946&req=5

Figure 15: (a-c) Deformity in forehead region during inflation due to poor skin laxity leading to failure. Device drained, deflated removed and site sutured
Mentions: The goal of tissue expansion is to create adequate amount of local tissue that matches in color and texture, which would give esthetically pleasing results. In addition, the advancement of local flap ensure adequate blood supply to the region, ensuring proper healing and success of the expanded flap. Owing to expansion, donor site morbidity can also be minimized to a greater extent. Since the time of its inception and advocacy, the technique has not been free from disadvantages [Figures 11–14]. It was a highly sensitive technique and rate of complications were large. Advantages of tissue expansion are (i) No deforming secondary defects; (ii) No distant flaps; (iii) Best color match, texture, hair bearing; (iv) Better vascularity; (v) best survival of the reconstruction. The disadvantages or discomfort include: (i) Frequent office visits for inflation or prolonged stay; (ii) discomfort and; (iii) Deformity during inflation.[1]

Bottom Line: Descriptive statistics, Kruskal-Wallis and Mann-Whitney tests were applied as required and a P ≤ 0.05 was taken as significant.Trauma contributed to greater number of defects (57.1%).Owing to ease of access and better results, more expanders have been placed in cheek (50%), followed by neck (33.33%).

View Article: PubMed Central - PubMed

Affiliation: Director and Consultant Maxillofacial Surgeon, Balaji Dental and Craniofacial Hospital, Teynampet, Chennai, Tamil Nadu, India.

ABSTRACT

Introduction: Tissue expansion is a versatile technique for craniofacial soft tissue defects. It has been extremely useful to restore the form and function along with good esthetics that were otherwise unobtainable.

Objectives: To review the use of tissue expansion in the craniofacial region, with particular emphasis on indication, site, days, volume of the defect and tissue expansion used along with complications.

Materials and methods: Retrospective review of data on 18 expanded flap reconstructions performed in 14 patients during the period 2008-2013. Tissue expanders were placed on a subcutaneous plane above the fascia and inflated weekly. The expanded skin was used as a transposition flap for the reconstruction. Data were collected from archival records and tabulated in SPSS. Descriptive statistics, Kruskal-Wallis and Mann-Whitney tests were applied as required and a P ≤ 0.05 was taken as significant.

Results: Trauma contributed to greater number of defects (57.1%). The most common defect occurs in face/cheek compartment (57.15%) followed by nose (35.71%). Owing to ease of access and better results, more expanders have been placed in cheek (50%), followed by neck (33.33%). The mean defect size was 2983.58 ± 828.27 mm(2), required 32.14 ± 6.31 days, 335.6 ± 156.51 ml in 5.29 ± 1.5 cycles of tissue expansion. The mean rate of expansion was 59.17 ± 16.27, 69.11 ± 30.19 and 62.6 ± 25.75 for forehead, face/cheek and neck cases respectively (P = 0.873).

Discussion: Laxity of skin appears to be a good indicator of the rate of the expansion. The most favorable site for tissue expansion is cheek followed by neck. The study also shows that tissue expansion is an efficient and valuable technique for reconstruction of large craniofacial skin defects.

No MeSH data available.


Related in: MedlinePlus