Department for Cranio- and Maxillofacial Surgery, Heinrich-Heine-University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany.
Clin Oral Investig. 2013 Mar;17(2):573-8. doi: 10.1007/s00784-012-0747-8. Epub 2012 May 6.
The repair of skin defects in the head and neck region still poses a significant problem for many clinicians. Tissue expansion is described as a treatment option providing good color, texture, and thickness match of the expanded skin. Unfortunately, the complication rates for tissue expansion range from 0 to 48 %. Therefore, the purpose of this study was to investigate risk factors for the use of tissue expanders in head and neck reconstructions.
Forty-nine patients with skin deficits in the head and neck area underwent tissue expansion. Sixty-two implanted expanders were analyzed regarding the various complications and the success rate.
The success rate of treated patients was 37 (75.5 %) of all 49 included patients. The most frequent cause for the skin deficit was a tumor resection near the tip of the nose followed by skin deficits resulting after craniectomy. Interestingly, a higher number of expanders and a larger volume were significantly associated with a worse outcome. There was a trend of association between larger defect size and failure, too.
The internal tissue expansion is a suitable technique for skin reconstruction in the head and face area. Compared to distant or free flaps, it often offers a better cosmetic outcome. In very large defects (>100 cm(2)) or when more than two expanders are needed, the failure rate increases. In these cases, other treatment options are recommended.
The internal tissue expansion is a suitable technique for skin reconstruction in the head and face area.
头颈部皮肤缺损的修复仍然是许多临床医生面临的重大难题。组织扩张被描述为一种治疗选择，可以提供良好的颜色、质地和厚度匹配的扩张皮肤。不幸的是，组织扩张的并发症发生率为 0 至 48%。因此，本研究旨在探讨头颈部重建中使用组织扩张器的相关风险因素。
49 例头颈部皮肤缺损患者接受了组织扩张。分析了 62 个植入扩张器的各种并发症和成功率。
49 例纳入患者中，治疗成功率为 37 例（75.5%）。最常见的皮肤缺损原因是鼻尖附近的肿瘤切除，其次是颅骨切除后的皮肤缺损。有趣的是，扩张器数量较多和体积较大与预后较差显著相关。缺损面积较大与失败也存在一定的相关性。
内置组织扩张是头面部皮肤重建的一种合适技术。与远距离或游离皮瓣相比，它通常能提供更好的美容效果。在非常大的缺损（>100cm²）或需要使用两个以上扩张器的情况下，失败率会增加。在这些情况下，建议选择其他治疗方案。
内置组织扩张是头面部皮肤重建的一种合适技术。
