Systematic Review of Tissue Expansion: Utilization in Non-breast Applications

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Tissue Engineering

Background:

• Tissue expansion is a reconstructive method offering well-vascularized local tissue.
• Existing literature primarily covers breast, burn, and pediatric applications.
• Less traditional uses of tissue expansion are prevalent but under-documented.

Purpose of the Study:

• To systematically review the utilization of tissue expansion in less traditional reconstructive circumstances.
• To analyze expander specifications, expansion processes, and complication rates in these applications.

Main Methods:

• Systematic review of publications on non-breast applications of tissue expansion.
• Data collection on expander details, expansion protocols, and complications.
• Analysis of collected variables.

Main Results:

• 166 publications detailed tissue expansion for ear, cranioplasty, abdominal wall, orthopedic, and genital reconstruction.
• Penile/scrotal and vaginal/vulva reconstructions exhibited the highest rates of tissue expander failure, infection, and exposure.
• Complication rates for genital reconstruction: penile/scrotal (failure 18.5%, infection 15.5%, exposure 12.5%) and vaginal/vulva (failure 20.6%, infection 10.3%, exposure 6.9%).

Conclusions:

• Tissue expansion provides essential skin for definitive reconstruction, avoiding free tissue transfer.
• Despite inherent risks, tissue expansion is a valuable reconstructive tool.
• Aggregate failure rates for final reconstructions are comparable to those without pre-expansion, supporting its use in a staged approach.