Division of Plastic Surgery, Department of Surgery, University of British Columbia, Vancouver, Canada; Division of Plastic Surgery, Department of Surgery, BC Children's Hospital, Vancouver, Canada.
Division of Plastic Surgery, Department of Surgery, University of British Columbia, Vancouver, Canada; Division of Plastic Surgery, Department of Surgery, BC Children's Hospital, Vancouver, Canada.
J Pediatr Surg. 2019 Jul;54(7):1471-1476. doi: 10.1016/j.jpedsurg.2018.09.002. Epub 2018 Sep 18.
BACKGROUND/PURPOSE: Tissue expansion complication rates up to 40% have been reported in the pediatric population. This study aims to review one Canadian pediatric plastic surgeon's experience with tissue expansion by examining tissue expander and flap complication rates, and discussing important aspects of the tissue expansion experience.
This is a retrospective chart review of the medical records of all tissue expansion patients treated by the senior author during a ten-year period. Data were collected on patient demographics, tissue expansion details, complications, and outcomes, and were analyzed descriptively. The relationship between tissue expander complications and flap complications was analyzed with odds ratio.
Ninety-three expanders were placed in 24 patients during 49 sessions. Complications occurred in 19 expanders (10 patients; 16 sessions), resulting in premature removal of nine. Only one session was unsuccessful; the expander became exposed and was removed after 1 month. The odds of having a flap complication were three times greater with preceding tissue expander complication (not statistically significant).
Our study identifies a 20% expander complication rate in the pediatric population. Patients with tissue expander complications subsequently experienced more flap complications than those without tissue expander complications. Complications do not preclude successful reconstruction.
Prognostic.
II.
背景/目的：在儿科人群中，组织扩张并发症的发生率高达 40%。本研究旨在通过检查组织扩张器和皮瓣并发症的发生率，回顾一位加拿大儿科整形外科医生的组织扩张经验，并讨论组织扩张经验的重要方面。
这是对高级作者在十年期间治疗的所有组织扩张患者的病历进行的回顾性图表审查。收集了患者人口统计学、组织扩张细节、并发症和结果的数据，并进行了描述性分析。使用比值比分析了组织扩张器并发症与皮瓣并发症之间的关系。
93 个扩张器在 24 名患者的 49 次治疗中使用。19 个（10 名患者；16 次治疗）发生了并发症，导致 9 个提前取出。只有一次治疗不成功；扩张器在 1 个月后暴露并被取出。有组织扩张器并发症的患者发生皮瓣并发症的几率是没有组织扩张器并发症的患者的三倍（无统计学意义）。
我们的研究确定了儿科人群中 20%的扩张器并发症发生率。有组织扩张器并发症的患者随后发生皮瓣并发症的几率高于没有组织扩张器并发症的患者。并发症不会妨碍成功的重建。
预后。
II 级。
