INTRODUCTION: Tissue expanders have long been used for reconstructing large cutaneous and fascio-cutaneous defects in children. Previous studies have examined tissue expansion for all body regions, touching upon the head and neck regions. We present a focused review of our experience with cervicofacial tissue expansion in the pediatric population. MATERIALS AND METHODS: We retrospectively reviewed 89 children who underwent tissue expansion of the head and neck regions at Children's Hospital of Los Angeles. Most patients underwent multiple expander placements bringing the total expander number to 182. Indications for expansion included congenital nevus [N=39], burn scar [N=14], hemangioma/lymphangioma/arteriovenous malformation [N=11], scar due to trauma [N=10], congenital anomaly [N=5], sebaceous nevus [N=3], cutis aplasia [N=2], tumor [N=2], infection [N=2] and scleroderma [N=1]. RESULTS: Of the 182 expanders placed, 56 had an associated complication (30.8%). The most frequent complications included exposure, infection, leakage, migration, flap necrosis, wound separation, and skull bone remodeling. Expanders placed in the neck appeared to have the highest complication rate. CONCLUSIONS: This retrospective review identified a high complication rate in pediatric cervicofacial tissue expansion, which is similar to previously published studies. Despite these findings, tissue expansion in pediatric patients should continue to remain a viable reconstructive option, however, proper patient selection; patient education and informed consent involving a discussion of the expected treatment course and risk profile should be undertaken.
INTRODUCTION: Tissue expanders have long been used for reconstructing large cutaneous and fascio-cutaneous defects in children. Previous studies have examined tissue expansion for all body regions, touching upon the head and neck regions. We present a focused review of our experience with cervicofacial tissue expansion in the pediatric population. MATERIALS AND METHODS: We retrospectively reviewed 89 children who underwent tissue expansion of the head and neck regions at Children's Hospital of Los Angeles. Most patients underwent multiple expander placements bringing the total expander number to 182. Indications for expansion included congenital nevus [N=39], burn scar [N=14], hemangioma/lymphangioma/arteriovenous malformation [N=11], scar due to trauma [N=10], congenital anomaly [N=5], sebaceous nevus [N=3], cutis aplasia [N=2], tumor [N=2], infection [N=2] and scleroderma [N=1]. RESULTS: Of the 182 expanders placed, 56 had an associated complication (30.8%). The most frequent complications included exposure, infection, leakage, migration, flap necrosis, wound separation, and skull bone remodeling. Expanders placed in the neck appeared to have the highest complication rate. CONCLUSIONS: This retrospective review identified a high complication rate in pediatric cervicofacial tissue expansion, which is similar to previously published studies. Despite these findings, tissue expansion in pediatric patients should continue to remain a viable reconstructive option, however, proper patient selection; patient education and informed consent involving a discussion of the expected treatment course and risk profile should be undertaken.
Authors: Juan M Colazo; Brian C Evans; Angel F Farinas; Salam Al-Kassis; Craig L Duvall; Wesley P Thayer Journal: Tissue Eng Part B Rev Date: 2019-08 Impact factor: 6.389
Authors: Tara L Braun; Kristy L Hamilton; Laura A Monson; Edward P Buchanan; Larry H Hollier Journal: Semin Plast Surg Date: 2016-11 Impact factor: 2.314
Authors: Susanna Esposito; Rossella Sgarzani; Sonia Bianchini; Sara Monaco; Laura Nicoletti; Erika Rigotti; Marilia Di Pietro; Roberta Opri; Caterina Caminiti; Matilde Ciccia; Giorgio Conti; Daniele Donà; Mario Giuffré; Stefania La Grutta; Laura Lancella; Mario Lima; Andrea Lo Vecchio; Gloria Pelizzo; Giorgio Piacentini; Carlo Pietrasanta; Matteo Puntoni; Alessandro Simonini; Elisabetta Venturini; Annamaria Staiano; Nicola Principi Journal: Antibiotics (Basel) Date: 2022-04-11