Systematic Review of Tissue Expansion: Utilization in Non-breast Applications.
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2021-01-21
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Abstract
Background
Tissue expansion is a versatile reconstructive technique providing well-vascularized local tissue. The current literature focuses largely on tissue expansion for breast reconstruction and in the context of burn and pediatric skin/soft tissue replacement; however, less traditional applications are also prevalent. The aim of this study was to systematically review the utilization of tissue expansion in such less well-characterized circumstances.Methods
The authors conducted a systematic review of all publications describing non-breast applications of tissue expansion. Variables regarding expander specifications, expansion process, and complications were collected and further analyzed.Results
A total of 565 publications were identified. Of these, 166 publications described tissue expansion for "less traditional" indications, which fell into 5 categories: ear reconstruction, cranioplasty, abdominal wall reconstruction, orthopedic procedures, and genital (penile/scrotal and vaginal/vulva) reconstruction. While lower extremity expansion is known to have high complication rates, tissue expander failure, infection, and exposure rates were in fact highest for penile/scrotal (failure: 18.5%; infection: 15.5%; exposure: 12.5%) and vaginal/vulva (failure: 20.6%; infection: 10.3%; exposure: 6.9%) reconstruction.Conclusions
Tissue expansion enables index operations by providing additional skin before definitive reconstruction. Tissue expanders are a valuable option along the reconstructive ladder because they obviate the need for free tissue transfer. Although tissue expansion comes with inherent risk, aggregate outcome failures of the final reconstruction are similar to published rates of complications without pre-expansion. Thus, although tissue expansion requires a staged approach, it remains a valuable option in facilitating a variety of reconstructive procedures.Type
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Langdell, Hannah C, Mahsa Taskindoust, Heather A Levites, Catalin Mateas, Amanda R Sergesketter, Samantha J Kaplan, Jeffrey R Marcus, Detlev Erdmann, et al. (2021). Systematic Review of Tissue Expansion: Utilization in Non-breast Applications. Plastic and reconstructive surgery. Global open, 9(1). p. e3378. 10.1097/gox.0000000000003378 Retrieved from https://hdl.handle.net/10161/22411.
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Scholars@Duke
Samantha Kaplan
Sami is the Research and Education Liaison Librarian to the School of Medicine. She offers research services to School of Medicine teaching faculty, staff, and students. She works to enable and promote evidence-based practice at Duke Health.
- PhD, UNC Chapel Hill School of Information and Library Science
- MLIS, University of South Carolina
- BA, University of Georgia
Jeffrey Robert Marcus
My research parallels our specialized clinical programs at Duke. I am involved in clinical research looking comprehensively at outcomes of cleft care to develop standards for evaluating a team’s overall success. Based on a recent grant from the Centers for Disease Control (CDC), we are also participating with several centers to look specifically at academic, psychosocial, and surgical outcomes for all children with clefts born in North Carolina. We are committed to the technique of nasoalveolar molding for children with clefts and are engaged in analyzing its benefits. In rhinoplasty, we have developed a model for nasal respiratory physiology, and we are looking at the effects of specific surgical procedures on nasal airflow and resistance. Our Craniofacial imaging lab has developed sophisticated software to analyze cranial shape, and we use these techniques to define abnormal conditions and their treatment relative to normal. Lastly, our craniomaxillofacial trauma team continues to look at factors associated with facial trauma in North Carolina in order to implement techniques and processes to deliver optimal care and results.
Detlev Erdmann
Unless otherwise indicated, scholarly articles published by Duke faculty members are made available here with a CC-BY-NC (Creative Commons Attribution Non-Commercial) license, as enabled by the Duke Open Access Policy. If you wish to use the materials in ways not already permitted under CC-BY-NC, please consult the copyright owner. Other materials are made available here through the author’s grant of a non-exclusive license to make their work openly accessible.