Maamouri S, Zitouni K, Zairi I
Faculté de médecine de Tunis, Hôpital Charles Nicole, tunis el manar, Tunis, Tunisie.
Hôpital Charles Nicole, Tunis, Tunisie.
Ann Chir Plast Esthet. 2021 Oct;66(5):385-394. doi: 10.1016/j.anplas.2021.06.004. Epub 2021 Jul 28.
Tissue expansion is a key tool in the therapeutic arsenal that is proposed for repairing soft tissue losses of the head and neck. This technique, however interesting it may be, is not without its risks. The aim of this work is to identify the different steps of this procedure, determine the complications risk factors inherent to each step of the expansion and propose recommendations to improve functional and aesthetic results.
We carried out a retrospective study on tissue expansion of the head and neck over a period of 10 years extending from January 2009 to December 2018, with at least one year follow-up for each patient. Our study counted 63 patients with the placement of 98 prostheses. We considered the various variables involved in the expansion process in order to determine those that increase the risk of complications.
In our series we counted 66.3 % of complications and 22.4 % of failures. We found that a young age increased the risk of skin suffering and that smoking increased the risk of hematoma occurrence. Neck expansion was found to be the riskiest site of expansion followed by the scalp that increased the risk of exposure (especially the parietal section of the scalp). The face is considered as an interesting site for expansion. We found that the use of multiple expanders is an attractive alternative to iterative expansions and to the choice of large expanders.
Tissue expansion of the head and neck requires careful planning that takes into account each step of the process.
组织扩张是修复头颈部软组织缺损的治疗手段中的一项关键技术。然而，这项技术无论多么有趣，都并非没有风险。本研究的目的是明确该手术的不同步骤，确定扩张过程中每个步骤固有的并发症风险因素，并提出改善功能和美学效果的建议。
我们对2009年1月至2018年12月期间的10年头颈部组织扩张进行了回顾性研究，每位患者至少随访一年。我们的研究纳入了63例患者，共植入98个假体。我们考虑了扩张过程中涉及的各种变量，以确定那些会增加并发症风险的变量。
在我们的系列研究中，并发症发生率为66.3%，失败率为22.4%。我们发现年轻会增加皮肤受损的风险，吸烟会增加血肿发生的风险。颈部扩张被发现是最危险的扩张部位，其次是头皮，头皮扩张会增加暴露风险（尤其是头皮的顶叶部分）。面部被认为是一个有吸引力的扩张部位。我们发现使用多个扩张器是迭代扩张和选择大型扩张器的一个有吸引力的替代方案。
头颈部组织扩张需要仔细规划，要考虑到该过程的每一个步骤。
