Details

Autor(en) / Beteiligte

• Gosain, Arun K
• Turin, Sergey Y
• Chim, Harvey
• LoGiudice, John A

Titel

Salvaging the Unavoidable: A Review of Complications in Pediatric Tissue Expansion

Ist Teil von

• Plastic and reconstructive surgery (1963), 2018-09, Vol.142 (3), p.759-768

Ort / Verlag

United States: American Society of Plastic Surgeons

Erscheinungsjahr

2018

Quelle

MEDLINE

Beschreibungen/Notizen

• BACKGROUND:Tissue expansion, while a mainstay of reconstruction for pediatric cutaneous lesions, has significant complication rates. The authors review the complications in a single-surgeon series of tissue expansion to identify risk factors for complications and guide subsequent therapy so that reconstructive goals in patients can be met irrespective of intervening complications. METHODS:A retrospective chart review was conducted of all pediatric patients who underwent tissue expansion performed by the senior author (A.K.G.) over a 12-year period. In total, 282 expanders were placed in 94 patients. RESULTS:A total of 65 complications occurred in 39 of 94 patients (41.5 percent), involving 65 of the 282 expanders (23.0 percent) placed. Major complications that required expander removal included exposure (n = 11), rupture (n = 15), and migration (n = 11). The most frequent minor complications, which did not require immediate expander removal, included migration (n = 13) and port malfunction (n = 9). The majority of expanders were placed in the scalp (n = 114), followed by the torso (n = 100), face and neck (n = 52), and the extremities (n = 16). Serial expansion beyond the second round resulted in a marked increase in complications. Despite complications, tissue expansion in the majority of patients could be salvaged, and a satisfactory outcome was achieved. CONCLUSIONS:Families must be made aware that approximately one-third of patients may have a complication requiring additional surgery or modification of the initial reconstructive plan. However, these complications need not preclude attainment of reconstructive goals. CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic, IV.