Karagergou Eleni, Papas Athanasios, Foroglou Pericles, Demiri Euterpi
Plastic Surgery Department, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece.
J Plast Surg Hand Surg. 2012 Sep;46(3-4):167-71. doi: 10.3109/2000656X.2012.697384. Epub 2012 Jul 12.
We report our experience of using tissue expansion where we deal particularly with complications and their management. Forty patients had tissue expanded during a 5-year period (2005-2010). Indications included reconstruction of a scar (after a burn, after injury, or postoperative), congenital naevi, microtia, and breast reconstruction after mastectomy. Of the 50 expanders inserted, complications occurred in 12 (10 patients). Exposure and perforation of the expander were the most common complications, followed by infection, seroma, and local pain. In all cases, complications were managed successfully either by conservative treatment or by a single procedure. The reconstructive plan ended in an acceptable aesthetic result in 9 of the 10 complicated areas. The insertion of multiple expanders over extensive scar tissue and particularly over the lower limb, is associated with high morbidity. Selection of patients, identification of high-risk sites, and suggestions for treatment are important. When complications occur, immediate management usually results in a successful outcome.
我们报告了我们使用组织扩张术的经验，尤其涉及并发症及其处理。在5年期间（2005 - 2010年），有40例患者接受了组织扩张术。适应症包括瘢痕重建（烧伤后、受伤后或术后）、先天性痣、小耳畸形以及乳房切除术后的乳房重建。在插入的50个扩张器中，12个（10例患者）出现了并发症。扩张器外露和穿孔是最常见的并发症，其次是感染、血清肿和局部疼痛。在所有病例中，并发症通过保守治疗或单一手术均成功得到处理。在10个出现并发症的区域中，有9个区域的重建计划最终获得了可接受的美学效果。在广泛的瘢痕组织上，尤其是下肢，插入多个扩张器会导致高发病率。患者的选择、高危部位的识别以及治疗建议都很重要。当出现并发症时，立即处理通常会取得成功的结果。
