As'adi Kamran, Emami Seyed Abolhassan, Salehi Seyed Hamid, Shoar Saeed
Department of Plastic and Reconstructive Surgery, St Fatima Hospital, Iran University of Medical Sciences, Suite 2, Afra Tower, Khashayar Park, Africa Blvd., Tehran, 1915683913, Iran.
Burn Research Center, Motahari Burn Hospital, Iran University of Medical Sciences, Tehran, Iran.
Aesthetic Plast Surg. 2016 Aug;40(4):526-34. doi: 10.1007/s00266-016-0644-7. Epub 2016 May 13.
Tissue expansion has evolved reconstruction surgery by providing a great source of additional tissue for large skin defects. Nevertheless, wide application of tissue expander reconstruction is challenging due to high complication rates and uncertainty about final outcomes. Recently, endoscopy has shown promise in reconstructive surgeries using tissue expander placement.
This study aimed to compare outcomes between open and endoscopic-assisted neck tissue expander placement in reconstruction of post-burn facial scar deformities.
Through a randomized clinical trial, 63 patients with facial burn scars were assigned to an open group or endoscopic group for placement of 81 tissue expanders. The complication rate, operative time, length of hospital stay, and time to full expansion were compared between the two groups.
Thirty-one patients were assigned to the open group and 32 patients to the endoscopic group. The average operative time was significantly reduced in the endoscopic group compared with the open group (42.2 ± 3.6, 56.5 ± 4.5 min, p < 0.05). The complication rate was significantly lower in the endoscopic group than the open group (6 vs. 16, p < 0.05). Hospital stay was also significantly diminished from 26.3 ± 7.7 h in open group to 7.4 ± 4.5 h in endoscopic group (p < 0.0001). There was a significant reduction in time to full expansion in the endoscopic group as compared with the open group (93.5 ± 10.2 vs. 112.1 ± 14.2 days, p = 0.002).
Endoscopic neck tissue expander placement significantly reduced operative time, the postoperative complication rate, length of hospital stay, and time to achieve full expansion and allowed early initiation of expansion and remote placement of the port in relation to the expander pocket.
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组织扩张术通过为大面积皮肤缺损提供大量额外组织，推动了重建外科的发展。然而，由于并发症发生率高以及最终结果的不确定性，组织扩张器重建术的广泛应用面临挑战。近来，内窥镜检查在使用组织扩张器植入的重建手术中显示出前景。
本研究旨在比较开放式与内窥镜辅助下颈部组织扩张器植入在烧伤后面部瘢痕畸形重建中的效果。
通过一项随机临床试验，将63例面部烧伤瘢痕患者分为开放式组或内窥镜组，植入81个组织扩张器。比较两组的并发症发生率、手术时间、住院时间和完全扩张时间。
31例患者被分配至开放式组，32例患者被分配至内窥镜组。与开放式组相比，内窥镜组的平均手术时间显著缩短（42.2±3.6、56.5±4.5分钟，p<0.05）。内窥镜组的并发症发生率显著低于开放式组（6例对16例，p<0.05）。住院时间也从开放式组的26.3±7.7小时显著减少至内窥镜组的7.4±4.5小时（p<0.0001）。与开放式组相比，内窥镜组的完全扩张时间显著缩短（93.5±10.2对112.1±14.2天，p=0.002）。
内窥镜下颈部组织扩张器植入显著缩短了手术时间、术后并发症发生率、住院时间和实现完全扩张的时间，并允许早期开始扩张以及将端口相对于扩张器囊袋进行远程放置。
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