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Is soft tissue expansion in lower limb reconstruction a legitimate option?
E Vögelin1, R de Roche, N J Lüscher
1Department of Surgery, University Hospital, Kantonsspital Basel, Switzerland.
British Journal of Plastic Surgery
|December 1, 1995
Summary
Tissue expansion is a successful technique for lower limb reconstruction, achieving a 67.6% success rate in patients with scars and ulcers. Careful patient selection and surgical technique are crucial for optimal outcomes.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Tissue Engineering
Background:
- Tissue expansion is a reconstructive technique used for soft tissue defects.
- Lower limb reconstruction presents unique challenges due to limited tissue availability and high mechanical stress.
Purpose of the Study:
- To evaluate the efficacy and outcomes of tissue expansion in lower limb reconstruction.
- To identify indications, contraindications, and factors influencing success rates.
Main Methods:
- A retrospective review of 34 patients who underwent 37 lower limb tissue expansion procedures between 1986 and 1994.
- Indications included scars, ulcers, and benign skin lesions, with some defects exceeding 5 cm.
- Follow-up averaged 4.5 years.
Main Results:
- Overall success rate was 67.6% (23/34 patients).
- Minor wound healing problems occurred in 44% of patients.
- Technical complications like leaking ports affected 6 patients initially but did not compromise final outcomes.
- The technique failed in 32% (11/34 patients), with 5 subsequently treated successfully by other means.
Conclusions:
- Tissue expansion is effective for localized scars, contour defects, and benign tumors in the lower limb.
- Contraindications include extensive scarred areas with compromised blood supply, vascular disease, and osteomyelitis.
- Patient compliance and surgeon's technique are critical for successful lower limb reconstruction using tissue expansion.