[The use of expanders in soft-tissue plastic-reconstructive surgery].

Thirty-six years ago, Neumann was the first to practically implement skin expansion by means of subcutaneous rubber balloon inflation. After discovery of the silicone elastomer (1970), Padovan initiated the wide application of expanders in practice. Ever since then, the latter have conclusively demonstrated their contribution to plastic and reconstructive surgery in handling skin and soft-tissue defects in all parts of the body. The preparation and utilization of expanders are closely linked to the goals pursued, and evolve through several stages: 1) selection of the size and number of expanders, 2) choice of expander consistent with the valve type, 3) choice of the site and orientation of the incision for subcutaneous puch formation for the expander, 4) depth of expander insertion, 5) size of the punch for expander, valve and tube. After insertion of the silicone balloon (expander) subcutaneously, its inflation with serum is begun. Recently, early (for 24 hours) and quick (for 7-10 days) inflation of the expander is resorted to. The tolerance of both tissues involved, and patient is the basic criterion for practical implementation of the technique described. As any operative intervention and procedure, the use of expanders is associated with a number of complications. In general they are divided in: 1. minor--where discontinuation of the expansion process is unnecessary, but it is prolonged until the planned extension is attained, and 2. major--necessitating complete discontinuation of the process of expansion and performing additional procedures.