Widgerow Alan D, Murdoch Marshall, Edwards Gereth, Norval Carla
Division of Plastic Surgery, Department of Surgery, University of Witwatersrand and Linksfield Park Clinic, Johannesburg, South Africa.
Aesthetic Plast Surg. 2007 May-Jun;31(3):299-305. doi: 10.1007/s00266-006-0229-y.
Tissue expansion has been used as a technique to increase the amount of skin (and/or soft tissues) available for closing a defect or reconstructing an anatomic unit. Although the technique has undergone many modifications, the basic principles have remained more or less constant. The shortcomings of tissue expansion have remained unsolved for many years, namely, long periods of expansion with concomitant abnormal appearance with increased risk of complications over this extended period. Decreasing the expansion period would significantly contribute to patient convenience, decreased costs, and improved acceptance of the technique. This would need to be done within a background of safety without compromise to the reconstructive effort. With minor modification to the existing tissue expanders and their attachments together with modified patient-controlled infusion devices, a new method has been devised for tissue expansion in which the patient can control and expedite the entire process. As "proof of concept," 10 patients were selected for this trial. All had undergone mastectomies without concomitant radiotherapy. Successful full expansion, beginning the day after surgery, was achieved in all cases in approximately 3 weeks with minimal complications. Patent pending design modifications have been made that expedite the process, making it easier, more efficient, and cheaper to achieve full expansion. Although the numbers in this series were small, proof of concept was achieved, and trials are ongoing with increasing numbers expected. The concept is applicable to all forms of tissue expansion, including aesthetic indications such as hair restoration, tubular breast correction, and the like.
组织扩张术已被用作一种增加可用于闭合缺损或重建解剖单元的皮肤（和/或软组织）量的技术。尽管该技术经历了许多改进，但其基本原理或多或少保持不变。组织扩张术的缺点多年来一直未得到解决，即扩张期长，在此延长期间伴有外观异常且并发症风险增加。缩短扩张期将显著提高患者的便利性、降低成本并提高对该技术的接受度。这需要在不影响重建效果的安全背景下进行。通过对现有组织扩张器及其附件进行微小修改，并结合改进的患者自控输注装置，设计出了一种新的组织扩张方法，患者可以控制并加快整个过程。作为“概念验证”，选择了10名患者进行该试验。所有患者均接受了乳房切除术且未接受同期放疗。所有病例均在术后第一天开始，约3周内成功实现完全扩张，并发症极少。已对正在申请专利的设计进行了修改，以加快该过程，使其更轻松、高效且成本更低地实现完全扩张。尽管该系列病例数量较少，但已实现概念验证，并且正在进行更多病例的试验。该概念适用于所有形式的组织扩张，包括美学适应症，如毛发修复、管状乳房矫正等。
