Wael M Elshaer1, Ashraf A Enab, Hisham M Elmanawi. 1. Plastic and General Surgery Department, Faculty of Medicine, Bani-Suef University, Bani-Suef City, Egypt. welshaer@hotmail.com
Abstract
INTRODUCTION: Reconstruction of the face and neck after burn necessitates high-quality tissue for improving the appearance. Tissue expansion provides a greater opportunity, but, unfortunately, with relatively high complication rates. One potential alternative to reduce these complications is to place the expander with the assistance of the endoscope. In this study, we evaluated endoscopically assisted tissue-expander placement for the treatment of face and neck deformities after burn. MATERIALS AND METHODS: Age, gender, site of burn to be reconstructed, shape and volume of expander inserted, expander volume reached after expansion, time reached to maximum volume expansion and complications for all patients having undergone endoscopically assisted tissue-expander placement were recorded during the period of the study. The details of the procedure used were described. RESULTS: A total of 14 expanders were placed assisted by an endoscope in 11 patients between April 2008 and October 2009. Anatomically, five expanders were placed in the neck, six expanders were placed in the cheek and three expanders were placed in the forehead. In all cases, tissue expansion was achieved without major complications; minor port complications occurred in two cases. CONCLUSION: Endoscopically assisted tissue-expander placement allows for the use of smaller incisions, which can be placed in more cosmetically acceptable areas and away from the expansion site. This benefit would reduce the risk of wound dehiscence, and permits expansion to be initiated earlier. We believe that this technique is a safe and effective method that needs to be confirmed with a comparative study.
INTRODUCTION: Reconstruction of the face and neck after burn necessitates high-quality tissue for improving the appearance. Tissue expansion provides a greater opportunity, but, unfortunately, with relatively high complication rates. One potential alternative to reduce these complications is to place the expander with the assistance of the endoscope. In this study, we evaluated endoscopically assisted tissue-expander placement for the treatment of face and neck deformities after burn. MATERIALS AND METHODS: Age, gender, site of burn to be reconstructed, shape and volume of expander inserted, expander volume reached after expansion, time reached to maximum volume expansion and complications for all patients having undergone endoscopically assisted tissue-expander placement were recorded during the period of the study. The details of the procedure used were described. RESULTS: A total of 14 expanders were placed assisted by an endoscope in 11 patients between April 2008 and October 2009. Anatomically, five expanders were placed in the neck, six expanders were placed in the cheek and three expanders were placed in the forehead. In all cases, tissue expansion was achieved without major complications; minor port complications occurred in two cases. CONCLUSION: Endoscopically assisted tissue-expander placement allows for the use of smaller incisions, which can be placed in more cosmetically acceptable areas and away from the expansion site. This benefit would reduce the risk of wound dehiscence, and permits expansion to be initiated earlier. We believe that this technique is a safe and effective method that needs to be confirmed with a comparative study.