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Endoscopic-assisted neck tissue expansion in reconstruction of facial burn injuries
Kamran As'adi1, Seyed Hamid Salehi, Saeed Shoar
1From the *Department of Plastic and Reconstructive Surgery, Hazrat Fatemeh Hospital, and †Department of General Surgery, Motahari Burn Hospital, Iran University of Medical Sciences, Tehran, Iran; and ‡Department of Surgery, Shariati Hospital, §Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, and ∥Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Background:
Endoscopic-assisted tissue expansion has been recently used in plastic surgery. However, there is limited evidence regarding its efficacy in reconstruction of facial burn injuries.
Aims:
Our study aimed to evaluate the utility of endoscopic-assisted neck tissue expansion in reconstruction of facial burn deformities.
Methods:
Through a prospective study, 42 consecutive patients with facial burn injuries attending a major referral center of plastic and reconstructive surgery in Iran underwent reconstruction of facial defects with endoscopic-assisted neck tissue expansion. Intraoperative events, expansion process, and postoperative outcomes were measured for this group of patients.
Results:
The mean ± SD injected volume for intraoperative expansion was 66 ± 3.7 mL (range, 35-80 mL). The mean ± SD operative time was 45.6 ± 3.5 minutes. Moreover, the mean ± SD distance between the main access incision and the expander pocket was 5.6 ± 1.2 cm. Time to achieve full expansion ranged between 12 and 16 weeks, and the expanded volume at the time of reconstruction ranged from 400 to 800 mL. All the patients had less than 24 hours of hospital stay after placement of tissue expanders. There were only 2 minor complications during the postoperative follow-up including 1 case of seroma and 1 case of severe pain, which were treated conservatively.
Conclusions:
Endoscopic-assisted neck tissue expansion is associated with lower complication rate, shorter duration of hospitalization, reduced operative time, earlier initiation of expansion, and faster expansion process. It could be a feasible alternative to open technique in reconstructing facial burns, allowing smaller incision at port site, far placement of tissue expander, and excellent visualization of operation site.
