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At least 145 records · Page 8Linked to original sources
PubMed2005

Treatment of scattered glass foreign bodies in both the superficial and deep neck: a case report.

There have not been any reports about scattered glass foreign bodies in the neck, while injuries of the head and neck region as a result of traffic accidents have been frequently reported. We report the case of a 17-year-old male injured in a traffic accident, with scattered glass foreign bodies in both the superficial and deep neck. A CT scan indicated the existence of numerous glass foreign bodies in the various layers of the neck. Most of the foreign bodies were very fine or sand-like. The wounded skin was keloidal and expected to lead to remarkable facial edema of the left side. The foreign bodies and cervical keloidal lesions with small pieces of glass were carefully removed, and then reconstruction was conducted in stages using tissue expanders. The facial edema was reversed and the aesthetic reconstruction satisfied the patient.

Accidents, Traffic↗
PubMed2005

A novel procedure using a tissue expander for management of persistent alveolar fistula after lobectomy.

We treated a patient with postlobectomy persistent alveolar fistula using a tissue expander, which is a prosthesis widely used in plastic surgery. The patient had thoracic empyema develop after right bilobectomy for lung cancer, and consequently underwent drainage of empyema followed by muscle flap closure for alveolar fistula. A residual space remained, and air leak persisted. However, implanting and expanding a tissue expander enabled us to tightly fix the flap on the raw pulmonary surface, which eventually solved the air leak. The tissue expander greatly contributed to muscle flap closure for a persistent alveolar-pleural fistula with a large remaining thoracic space.

Carcinoma, Non-Small-Cell Lung↗
PubMed2004

Other ways to use tissue expanded flaps.

Tissue expansion can arguably be regarded as one of the revolutions in reconstructive plastic surgery. Another three applications (illustrated by three case reports) for tissue expansion are presented.

Burns↗
PubMed2005

Immediate breast reconstruction with definitive anatomical implants after skin-sparing mastectomy.

One-stage breast reconstruction with definitive implants was the original method of breast reconstruction. It gave a round breast with a fixed shape. Lack of skin after mastectomy was the main concern who led to the development of techniques to provide 'new' breast skin such as autogenous reconstruction and tissue expanders. This made the use of definitive implants almost obsolete. Since skin-sparing mastectomy (SSM) basically removes the mammary gland and the nipple-areolar complex preserving almost all mammary skin, it makes the use of definitive implants in immediate breast reconstruction possible again. Moreover, the advent of anatomically shaped implants overcomes the drawback of round shape: the anatomical implant with hyperprojected lower pole and short upper pole matches very well the profile of a real breast. The authors report their experience in 36 immediate breast reconstruction after SSM with short upper pole-hyperprojected silicone gel prostheses carried out between October 2001 and October 2003. In most cases SSM is performed through a circumareolar incision. Axillary dissection is preferably performed through the same incision. The anatomical implant is placed in a submuscular position superiorly and in a subfascial pocket inferiorly. Because of skin redundancy and easy distension of subfascial tissue in the inferior pole of the breast, the implant fills the skin of the inferior mammary pole without needing any skin expansion. Whenever possible, the skin incision is closed with a purse-string suture. The skin will look very wrinkled at the end of the surgery, but it will flatten out in a few weeks. The contralateral breast is simultaneously corrected, if needed. Outcome was assessed by evaluation of photographs performed by the authors, by the patients themselves and by a blinded group of surgeons who evaluated breast volume and shape, breast symmetry, and overall outcome. More than 90% of each of these parameters was scored as good or excellent. Complication rates was low with a 8.3% rate. The use of definitive implants in immediate breast reconstruction after SSM is a one-stage breast reconstruction with low morbidity and very good results, and it is associated with high level of patient and surgeon satisfaction.

Adult↗
PubMed2005

Two staged breast reconstruction following prophylactic bilateral subcutaneous mastectomy.

The aim of this retrospective study was to evaluate the results in patients who underwent bilateral subcutaneous mastectomy (BSCM) for prophylaxis against invasive breast cancer. All patients were operated on with the same protocol regarding indications and surgical method. Reconstruction was completed in two stages with tissue expanders and permanent round or shaped rough textured gel filled silicone implants. The study includes 52 patients with a mean age of 39.5 years operated on in the period 1991-2000; the period of follow-up ranged between 3 and 12 years with a mean of 7. In this series, not a single case of invasive cancer developed, and the aesthetic results are considered very satisfactory. This data strengthens the case of subcutaneous mastectomy as a valid prophylactic operation.

Adult↗
PubMed2005

Breast expander ports appear to be safe after multiple perforations.

It has been suggested in the literature that inflation ports of breast tissue expanders can be a major source of leakage. An experimental study with a 23G and subsequently with a 21G injection needle into the port membrane of three inflation ports was performed. After 100 perforations with each needle per port no leakage was detected and no material from the membrane could be identified in the needle lumens. The authors conclude that multiple needle perforations into the injection port are unlikely to be the cause for deflation of breast tissue expanders due to leakage.

Breast Implants↗
PubMed2005

Rupture of an expander prosthesis mimics axillary cancer recurrence.

Regional silicone gel migration from a ruptured breast implant has been reported at different locations including the upper extremity, chest wall muscles, axilla and back. We report a patient who presented with an axillary mass that mimicked a regional recurrence 5 years after breast cancer reconstruction with a latissimus dorsi musculocutaneous flap and silicon gel expander-prosthesis. Surgical exploration revealed that the mass contained silicone gel around the port of the breast expander that had ruptured. The mass was confluent with an intracapsular silicone leak through a tract along the tube of the expander port.

Breast Implants↗
PubMed2003

Expanded occipito-cervico-pectoral flap for reconstruction of burned cervical contracture.

Postburn neck contracture and hypertrophic scarring can cause functional limitation and aesthetic disfigurement. Reconstruction of severe deformities and scar of neck following healing from burns confronts the surgeon with some of the most challenging problems in reconstructive surgery. Through knowledge of available reconstructive technique accurate diagnosis of tissue deficiency and secondary distortion, imaginative planning and definitive, careful execution of ones surgical plan are the bare minimum items for achieving improvement in a burned deformed neck. The aim of this article is to assess the role of expanded occipito-cervico-pectoral (o-c-p) flap for reconstruction in a series of four patients with severe burn scar of neck and involvement of shoulder back but intact anterior aspect of chest. This is an alternative method of reconstruction burn scar of neck area.

Adolescent↗
PubMed2006

Overexpansion technique in burn scar management.

Overexpansion techniques are useful in overcoming a shortage of donor site for expansion: the aim of the authors was to verify whether this technique should be chosen instead of serial expansions for creation of wider and more malleable flaps for reconstruction. From 1993 to May 2005 we have overexpanded 59 patients with burn scars. The patients always underwent reconstruction at least 2 years after complete healing. Almost any body region capable of expansion has been overexpanded. The technique is illustrated here in the reconstruction of scalp, neck, trunk and thigh. Tissue expander original volume ranged from 450 to 800 cc: the silicon implant shape was both round and rectangular. Mean overinflation was 3.6 times beyond the stated vendor's maximum volume. The principle ratios were performed in the trunk (4.375) and in the lower extremities (4.125). The largest volume instilled in a single tissue expander was 3,500 cc. Overall expansion length was on average 172.6 days (range: 101-248). All patients were compliant with inflation once a week. The reconstructions were planned as the expansion of a transposition or an advancement flap. All patients had completion of their reconstruction with satisfactory resolution of their problem: complications occurred in three of all hyperinflated prostheses. Tissue overexpansion, if carefully planned and conducted, allows the completion of reconstruction in one-stage. Instead of serial expansions, it enhances patient compliance and reduces cost.

Adolescent↗
PubMed2007

Tissue expansion in burn sequelae repair.

Burns may cause emotional, aesthetic and functional sequelae. Extended or hypertrophic scars are usually difficult to repair using local tissues, and the use of skin grafts may cause further injuries to the donor sites. The use of tissue expanders may offer a better option in the treatment of burn sequelae. This is a report on our experience using tissue expanders in 54 cases (23 patients) of burn sequelae located in different anatomical areas. Fourteen of the patients were female and nine male ranging in age between 5 and 48. The expanders were placed in the subgaleal, submuscular, subfascial or subcutaneous planes. Skin expansion was completed in 50 cases (92.5%). The injured area was removed by advancement flaps in 44 cases and by transposition flaps in 6 of them. Primary expansion was performed in 42 cases and reexpansion in 12. The rate of complications was 24.07%, of which 30.8% were considered to be absolute and 69.2% relative. Tissue expansion is an excellent option for burn sequelae treatment because it provides skin of similar local characteristics and does not damage the donor site. The procedure can be repeated in the event of major sequelae (reexpansion).

Adolescent↗
PubMed2004

Hair deformities.

To be able to treat the wide spectrum of hair deformities, a surgeon must possess a wide spectrum of skills in HRS, cosmetic surgery, and reconstructive surgery. Specific education and training in HRS is not a traditional part of formal surgical training, although much information is available through several national and international organizations. Being sensitive to the unique variables associated with HRS increases the chances of achieving a superior functional and cosmetic result when treating significant hair deformities.

Adult↗
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↗