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Distant blunt forceps dissection in tissue expander insertion: A novel technique.
Oren Weissman1, Gabriel Hundeshagen2, Jonathan Bank3
1Chaim Sheba Medical Center at Tel HaShomer, Department of Plastic and Reconstructive Surgery, Tel Aviv, Israel.
Plastic Surgery (Oakville, Ont.)
|April 26, 2017
Summary
This study presents a novel technique for tissue expansion using remote dissection and hydrodissection, reducing expansion time and costs. Complication rates were moderate, comparable to other methods, with infection linked to multiple expander placements.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Biomaterials Engineering
Background:
- Tissue expansion is crucial for reconstructing defects, particularly burn scars.
- Traditional methods can be time-consuming and require specialized equipment.
Purpose of the Study:
- To describe and evaluate a novel technique for tissue expansion using remote dissection and hydrodissection.
- To assess the efficacy, safety, and cost-effectiveness of this approach compared to traditional methods.
Main Methods:
- A technique involving distant incisions for expander placement and remote pocket creation using hydrodissection and blunt forceps.
- Placement of 81 expanders in 30 patients, primarily for burn scar reconstruction.
- Analysis of complication rates, including surgical site infection and hematoma.
Main Results:
- No intraoperative bleeding complications, except in one case of severe subdermal fibrosis.
- Postoperative complication rate was 24%, with surgical site infection (16.6%) correlated with multiple expander placements.
- Expander extrusion occurred in one patient; receiving ≥2 expanders simultaneously increased complication risk.
Conclusions:
- The described technique offers reduced expansion time and cost-effectiveness compared to open or endoscopic approaches.
- Complication rates are moderate and comparable to existing methods.
- Careful patient selection and limiting simultaneous expander placement may mitigate risks.