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Serial tissue expansion for reconstruction of burns of the head and neck

D A Hudson1, E Arasteh

  • 1Department of Plastic and Reconstructive surgery, Red Cros Childrens' Hospital and University of Cape Town, Cape Town, South Africa. hudsond@ucrgsh1.uct.ac.za

Insights

Serial tissue expansion is a valuable technique for head and neck burn reconstruction in children. This method, involving multiple tissue expanders, proved effective in scar revision for pediatric burn patients.

Area of Science:

  • Plastic Surgery
  • Pediatric Burn Reconstruction
  • Tissue Expansion Techniques

Background:

  • Reconstruction of head and neck burns in children presents unique challenges.
  • Limited data exists on the efficacy of serial tissue expansion for pediatric burn scar management.
  • Tissue expansion offers a potential solution for obtaining adequate skin grafts.

Purpose of the Study:

  • To evaluate the effectiveness and complication rates of serial tissue expansion for head and neck burn reconstruction in pediatric patients.
  • To assess the feasibility of multiple expansion procedures in a single patient.
  • To determine if serial tissue expansion is a viable reconstructive option for pediatric burn scars.

Main Methods:

  • A retrospective review of 14 pediatric patients (mean age 7.8 years) undergoing serial tissue expansion for head and neck burns over an 11-year period.
  • A total of 67 tissue expanders were used across multiple expansion sessions per patient.
  • Burn scars were completely excised or reduced in size following expansion.

Main Results:

  • Patients underwent between one and four expansion procedures.
  • The major complication rate (expander extrusion) was 21% for the first expansion, 25% for the second, and 14% for subsequent expansions.
  • Successful scar excision or reduction was achieved in all cases.

Conclusions:

  • Serial tissue expansion is a feasible and effective method for reconstructing head and neck burn scars in children.
  • The technique allows for significant tissue recruitment, facilitating complete scar removal or reduction.
  • Further consideration of serial tissue expansion is warranted for pediatric burn reconstruction.

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