Lindsay A Bjornson1, Marija Bucevska1, Cynthia Verchere2. 1. Division of Plastic Surgery, Department of Surgery, University of British Columbia, Vancouver, Canada; Division of Plastic Surgery, Department of Surgery, BC Children's Hospital, Vancouver, Canada. 2. Division of Plastic Surgery, Department of Surgery, University of British Columbia, Vancouver, Canada; Division of Plastic Surgery, Department of Surgery, BC Children's Hospital, Vancouver, Canada. Electronic address: cverchere@cw.bc.ca.
Abstract
BACKGROUND/ PURPOSE: Tissue expansion complication rates up to 40% have been reported in the pediatric population. This study aims to review one Canadian pediatric plastic surgeon's experience with tissue expansion by examining tissue expander and flap complication rates, and discussing important aspects of the tissue expansion experience. METHODS: This is a retrospective chart review of the medical records of all tissue expansion patients treated by the senior author during a ten-year period. Data were collected on patient demographics, tissue expansion details, complications, and outcomes, and were analyzed descriptively. The relationship between tissue expander complications and flap complications was analyzed with odds ratio. RESULTS: Ninety-three expanders were placed in 24 patients during 49 sessions. Complications occurred in 19 expanders (10 patients; 16 sessions), resulting in premature removal of nine. Only one session was unsuccessful; the expander became exposed and was removed after 1 month. The odds of having a flap complication were three times greater with preceding tissue expander complication (not statistically significant). CONCLUSIONS: Our study identifies a 20% expander complication rate in the pediatric population. Patients with tissue expander complications subsequently experienced more flap complications than those without tissue expander complications. Complications do not preclude successful reconstruction. TYPE OF STUDY: Prognostic. LEVEL OF EVIDENCE: II.
BACKGROUND/ PURPOSE: Tissue expansion complication rates up to 40% have been reported in the pediatric population. This study aims to review one Canadian pediatric plastic surgeon's experience with tissue expansion by examining tissue expander and flap complication rates, and discussing important aspects of the tissue expansion experience. METHODS: This is a retrospective chart review of the medical records of all tissue expansion patients treated by the senior author during a ten-year period. Data were collected on patient demographics, tissue expansion details, complications, and outcomes, and were analyzed descriptively. The relationship between tissue expander complications and flap complications was analyzed with odds ratio. RESULTS: Ninety-three expanders were placed in 24 patients during 49 sessions. Complications occurred in 19 expanders (10 patients; 16 sessions), resulting in premature removal of nine. Only one session was unsuccessful; the expander became exposed and was removed after 1 month. The odds of having a flap complication were three times greater with preceding tissue expander complication (not statistically significant). CONCLUSIONS: Our study identifies a 20% expander complication rate in the pediatric population. Patients with tissue expander complications subsequently experienced more flap complications than those without tissue expander complications. Complications do not preclude successful reconstruction. TYPE OF STUDY: Prognostic. LEVEL OF EVIDENCE: II.