Tissue expansion.

Tissue expansion in the upper extremity is a valuable technique with expanding indications and expected outcomes. The primary indications are coverage problems after trauma, but the technique is also applicable to defects caused by treatment of hemangioma, nevi, tattoos, or hypertrophic scars as well as correction of unstable tissue or as an alternative to free tissue transfer. The advantage of expansion-specifically, match in tissue texture and retention of sensibility-may be more important in the hand and upper extremity than in other areas. The inevitable capsule that forms around the expander does provide a smooth gliding surface for tendons in the forearm and wrist. In conclusion, tissue expansion of the upper extremity offers the surgeon the ability to improve cosmesis in one location without having to sacrifice cosmesis at a second site.