Division of Pediatric Surgery, Emory University School of Medicine/Children's Healthcare of Atlanta, Atlanta, GA 30322, USA.
J Pediatr Surg. 2011 Feb;46(2):372-7. doi: 10.1016/j.jpedsurg.2010.11.020.
BACKGROUND/PURPOSE: Closure of abdominal wall defects in children poses a challenge for pediatric surgeons. We describe a technique using tissue expanders placed either intraperitoneally or in the abdominal wall to aid in the reconstruction of a variety of complex abdominal wall defects.
The tissue expanders are inserted under general anesthesia. Initial expansion is done in the operating room with attention to peak airway pressure, urine output, and end-tidal carbon dioxide. The expanders are inflated in the outpatient setting via percutaneous access until the calculated inflation volume is achieved. They are then removed; and definitive closure is accomplished using a combination of native tissue flaps, abdominal component separation techniques, biomaterials, and synthetic material.
Six children underwent tissue expansion for treatment of abdominal wall defects (omphalocele, n = 3), trauma (n = 1), and thoracopagus twins (n = 1 pair). One to 4 expanders were used per patient, with all having a successful reconstruction of their abdominal walls. Two to 3 operations were required to restore abdominal domain and consisted of expander insertion, removal with reconstruction, and possible revision of the reconstruction.
Tissue expanders possess a broad range of applications for abdominal wall reconstruction and can be used in patients of all ages.
背景/目的：儿童腹壁缺损的闭合对小儿外科医生来说是一个挑战。我们描述了一种使用组织扩张器的技术，该技术可用于帮助重建各种复杂的腹壁缺损。
组织扩张器在全身麻醉下插入。初始扩张在手术室中进行，同时注意气道峰压、尿量和呼气末二氧化碳。通过经皮途径在门诊环境中对扩张器进行充气，直到达到计算出的充气量。然后将其取出；使用天然组织瓣、腹部组件分离技术、生物材料和合成材料的组合来完成确定性闭合。
6 名儿童因腹壁缺损（脐膨出，n=3）、创伤（n=1）和胸腹联体双胞胎（1 对）接受了组织扩张治疗。每位患者使用 1 至 4 个扩张器，所有患者的腹壁重建均成功。为恢复腹部区域，需要进行 2 至 3 次手术，包括扩张器插入、移除和重建，以及可能的重建修正。
组织扩张器在腹壁重建中具有广泛的应用，并可用于所有年龄段的患者。
