Postburn scalp reconstruction using a self-filling osmotic tissue expander.

Tissue expanders have been used in the past few decades for various reconstructive procedures. The conventional expander requires serial filling injections in repeated visits over a few months period, and carries a substantial complication rate. An osmotic self-filling expander was invented ten years ago, but has still not gained a wide spread use. We describe here our first experience with this expander in reconstruction of a post-burn scalp scar in a young patient, and discuss its advantages: no filling injections are needed, thus lowering the possibility of infection and significantly reducing the number of required visits to the outpatient clinic; the swelling is much more gradual and subtle and there is no pain that usually follows the filling injection; the small initial volume of the expander requires a relatively small pocket and can be performed under local anesthesia and results in a relatively short scar.