Efficacy of cycled hyperinflation for rapid tissue expansion

Temporary hyperexpansion at each filling session has previously been confirmed to increase the inflation volume in a conventional expansion procedure. This study employed eight young pigs to evaluate the effect of hyperinflation of this type in rapid expansion performed on 10 consecutive days. Hyperinflation to 120 mmHg for 4 minutes and deflation to 40 mmHg for 2 minutes was repeated five times on the experimental side. This cycled hyperinflation was found to increase the filling volume by 49 percent when compared with the contralateral side, which was not cycled or hyperinflated (control) (p < 0.01). The increase in surface area of the entire skin over the balloon was 178.1 percent in the hyperinflation group and 132.8 percent in the controls (p < 0.01). The actual expansion in surface area was not significantly different: 44.4 percent in the hyperinflation group and 45.7 percent in the control group. The additional gain of skin by cycled hyperinflation was the result of recruitment. The control group required 5 more days to achieve the same amount of skin but resulted in more true expansion and less recruitment. It is concluded that the cycled hyperinflation technique may shorten the time period of the whole reconstruction procedure but may produce an aesthetic deformity and flap necrosis.