Oestreich K, Flügel A, Raab N, Germann G, Jester A
Klinik für Hand-, Plastische und Rekonstruktive Chirurgie-Schwerbrandverletztenzentrum, Berufsgenossenschaftliche Unfallklinik Ludwigshafen.
Handchir Mikrochir Plast Chir. 2006 Aug;38(4):240-5. doi: 10.1055/s-2006-924418.
The use of the balloon dissector ("space maker") for the implantation of soft tissue expanders is illustrated and technical aspects and advantages are compared to the conventional method.
Over a 10-year period a group of 90 patients with evaluation records (m = 34, f = 56) was analysed retrospectively. The mean age was 23 years (range: 5 to 62 years). Overall, 164 expanders were implanted and in 73 cases (44.5%) a balloon dissector was used.
The mean intraoperative expander filling was increased up to 27% of the volume of the tissue expander after using the balloon dissector; in contrast it was 15% after conventional dissection. The mean duration of expansion was decreased by 9.8% after space maker dissection.
The use of the space maker is a scar-sparing technique. Time of operation and overall duration of expansion are reduced. Patient comfort is clearly improved. The negligible costs of a space maker are compensated by the cost reduction due to shorter operating time, fewer outpatient contacts and a low complication rate. The indications for the use of balloon dissectors are the expansion of skin (scar correction after burns, trauma, tumour), breast reconstruction and augmentation, and the prefabrication and rapid intraoperative expansion of musculocutaneous flaps.
本文展示了使用球囊分离器（“空间制造器”）植入软组织扩张器的方法，并将其技术方面和优势与传统方法进行了比较。
回顾性分析了一组90例有评估记录的患者（男性34例，女性56例），时间跨度为10年。平均年龄为23岁（范围：5至62岁）。总共植入了164个扩张器，其中73例（44.5%）使用了球囊分离器。
使用球囊分离器后，术中扩张器的平均填充量增加至组织扩张器体积的27%；相比之下，传统解剖法为15%。使用空间制造器进行解剖后，平均扩张持续时间减少了9.8%。
使用空间制造器是一种减少瘢痕的技术。手术时间和总体扩张持续时间缩短。患者舒适度明显提高。空间制造器的成本可忽略不计，而较短的手术时间、较少的门诊就诊次数和较低的并发症发生率所带来的成本降低则足以弥补这一成本。球囊分离器的使用适应证包括皮肤扩张（烧伤、创伤、肿瘤后的瘢痕矫正）、乳房重建和增大，以及肌皮瓣的预制和术中快速扩张。
