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Tissue expander complications in the pediatric burn patient
G P Pisarski1, D Mertens, G D Warden
1Department of Surgery, University of Cincinnati College of Medicine and the Shriners Burns Institute-Cincinnati Unit, Ohio, USA.
Plastic and Reconstructive Surgery
|September 12, 1998
Summary
Tissue expander use in pediatric burn reconstruction saw a significant decrease in complications. Improved surgical experience and protocols reduced issues like infection and leakage, enhancing patient outcomes.
Area of Science:
- Plastic Surgery
- Pediatric Burn Reconstruction
Background:
- Tissue expanders are valuable for pediatric burn reconstruction.
- Previous studies documented complication rates in tissue expander use.
Purpose of the Study:
- To review and compare complication rates of tissue expanders in pediatric burn patients over two distinct periods.
- To identify factors contributing to complication reduction.
Main Methods:
- Retrospective review of 403 tissue expanders in 301 pediatric patients from June 1984 to July 1995.
- Comparison of complication data from two periods: June 1984-June 1987 and July 1987-July 1995.
- Analysis of complication types (absolute and relative) and their relation to anatomical areas.
Main Results:
- Overall complication rate decreased significantly from 30% (1984-1987) to 18% (1987-1995).
- Infection was the most common absolute complication (48%) in the recent period.
- Leakage and exposure were common in the neck, face, ear, and supraclavicular areas due to mechanical stress.
Conclusions:
- Increased surgical experience and standardized protocols significantly reduced tissue expander complications in pediatric burn patients.
- Specific anatomical sites like the neck and face require careful management to prevent leakage and exposure.
- Lower extremity expansion was discontinued due to unsatisfactory results.
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