Risk factors for complications of tissue expansion: An updated systematic review and meta-analysis.

BACKGROUND

This study aimed to summarize risk factors for complications of tissue expansion using a meta-analysis of cohort studies.

METHODS

PubMed, Embase, and Cochrane Library were searched from January 1985 to January 2025 for retrospective cohort studies investigating at least one potential risk factor for complications of tissue expansion. The quality of individual studies was assessed using the Newcastle-Ottawa scale. We conducted meta-analysis with risk ratios calculated for complication event rates.

RESULTS

This review included 19 studies involving 1,673 participants. Two distinct subgroups (children only, adults and children) were identified. Strong evidence indicated that lower limb (relative ratio, 1.73; 95% confidence interval, 1.27-2.37), burn (relative ratio, 1.45, 95% confidence interval, 1.07-1.95), and myelomeningocele (relative ratio, 1.82; 95% confidence interval, 1.22-2.70) were the risk factors for premature removal of expansion in both children and adults.

CONCLUSION

This review identified lower limb, burn, and myelomeningocele are risk factors for complications of tissue expansion. Identifying modifiable risk factors is an urgent priority to improve prevention and treatment outcomes.