Clinical oral investigations · 2012
Tissue expanders for soft tissue reconstruction in the head and neck area--requirements and limitations.
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Handschel Jörg, Schultz Stefanie, Depprich Rita A, Smeets Ralf, Sproll Christoph, Ommerborn Michelle A, Naujoks Christian, Kübler Norbert R, Zimmermann André
Аннотация
OBJECTIVES: The repair of skin defects in the head and neck region still poses a significant problem for many clinicians. Tissue expansion is described as a treatment option providing good color, texture, and thickness match of the expanded skin. Unfortunately, the complication rates for tissue expansion range from 0 to 48 %. Therefore, the purpose of this study was to investigate risk factors for the use of tissue expanders in head and neck reconstructions.
MATERIALS AND METHODS: Forty-nine patients with skin deficits in the head and neck area underwent tissue expansion. Sixty-two implanted expanders were analyzed regarding the various complications and the success rate.
RESULTS: The success rate of treated patients was 37 (75.5 %) of all 49 included patients. The most frequent cause for the skin deficit was a tumor resection near the tip of the nose followed by skin deficits resulting after craniectomy. Interestingly, a higher number of expanders and a larger volume were significantly associated with a worse outcome. There was a trend of association between larger defect size and failure, too.
CONCLUSIONS: The internal tissue expansion is a suitable technique for skin reconstruction in the head and face area. Compared to distant or free flaps, it often offers a better cosmetic outcome. In very large defects (>100 cm(2)) or when more than two expanders are needed, the failure rate increases. In these cases, other treatment options are recommended.
CLINICAL RELEVANCE: The internal tissue expansion is a suitable technique for skin reconstruction in the head and face area.
MATERIALS AND METHODS: Forty-nine patients with skin deficits in the head and neck area underwent tissue expansion. Sixty-two implanted expanders were analyzed regarding the various complications and the success rate.
RESULTS: The success rate of treated patients was 37 (75.5 %) of all 49 included patients. The most frequent cause for the skin deficit was a tumor resection near the tip of the nose followed by skin deficits resulting after craniectomy. Interestingly, a higher number of expanders and a larger volume were significantly associated with a worse outcome. There was a trend of association between larger defect size and failure, too.
CONCLUSIONS: The internal tissue expansion is a suitable technique for skin reconstruction in the head and face area. Compared to distant or free flaps, it often offers a better cosmetic outcome. In very large defects (>100 cm(2)) or when more than two expanders are needed, the failure rate increases. In these cases, other treatment options are recommended.
CLINICAL RELEVANCE: The internal tissue expansion is a suitable technique for skin reconstruction in the head and face area.
Предметные рубрики MeSH
Age FactorsAlopeciaCraniotomyDermatologic Surgical ProceduresEquipment DesignFaceFemaleHeadHumansMaleMiddle AgedNeckNose NeoplasmsPostoperative ComplicationsProspective StudiesPlastic Surgery ProceduresRisk FactorsSkinSkin NeoplasmsSkullSodium ChlorideSurgical Wound DehiscenceTissue ExpansionTissue Expansion DevicesTreatment Outcome