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Advantages of minimally invasive, balloon-dissector-assisted tissue expander placement: a clinical and experimental
Stephen J Kovach1, Kim E Koger, Bruce Klitzman
1Department of Plastic, Reconstructive, Oral, and Maxillofacial Surgery, Duke University Medical Center, Durham, NC 27710, USA. sjkovach@hotmail.com
Background:
Tissue expansion has been dependent upon healing the access incision after placement. Delay can be reduced with minimally placed expanders. Smaller, remote incisions allow for earlier expansion.
Methods:
Balloon-assisted tissue expander placement was evaluated in a pig model and compared with open placement. Open placement with delayed expansion versus minimally invasive placement with immediate expansion, and open placement with immediate expansion versus balloon dissection with delayed expansion were compared. Our clinical series with balloon dissector tissue-expander placement was reviewed. Fifty-two tissue expanders were placed minimally invasively and successfully expanded.
Results:
Use of balloon dissector in the pig model yielded a shorter reconstructive period, faster expansion, and greater flap advancement. Clinical results revealed no infections, dehiscence, extrusion, or hematomas. All cases had expansion begun intraoperatively and were successfully expanded.
Conclusions:
Minimally invasively placed expanders resulted in shorter expansion times, the ability to institute immediate expansion, and improved expansion compared with open placement.