Use of the subcutaneous tissue expander for delayed primary closure of flaps

Two cases of deforming, painful scars on the dorsum of the foot are presented. Simple excision and primary closure of these wounds was not possible. Subcutaneous tissue expanders were implanted proximal to the scar and inflated gradually. Once adequate expansion was obtained, the expanders were removed, and scars excised. Closure was obtained by a pedicle and rotational advancement flap, without stress on the skin over the defect. A discussion of the indications, techniques, and pitfalls of tissue expansion is provided.