Lin C H, Levin L S
Trauma and Emergency Surgery, and Department of Plastic and Reconstructive Surgery, Chang-Gung Memorial Hospital, Taipei, Taiwan.
Microsurgery. 1996;17(6):330-6. doi: 10.1002/(SICI)1098-2752(1996)17:6<330::AID-MICR8>3.0.CO;2-L.
Pre-expansion of free flaps augments flap size dimensions and provides delay of tissue by opening "choke" vessels, thus augmenting the territories of adjacent angiosomes. Pre-expansion of free tissue transfers has been used for reconstruction of large soft tissue defects. A secondary benefit is that the donor site, traditionally treated by skin graft, can be closed primarily. Using conventional techniques for free flap pre-expansion, blunt dissection may risk injury to the pedicle. Using balloon dissectors a large optical cavity can be created quickly through an avascular fascial cleft. This allows endoscopic exploration of the optical cavity and confirmation of placement of the tissue expander. In addition, balloon-assisted endoscopic tissue expander placement optimizes the hysteresis effect of skin stretching and offers the possibility of immediate fluid inflation, which ultimately shortens the time for free flap expansion prior to microsurgical transfer.
游离皮瓣预扩张可增大皮瓣尺寸，并通过开放“阻塞”血管实现组织延迟，从而扩大相邻血管体的区域。游离组织移植的预扩张已用于大型软组织缺损的重建。另一个好处是，传统上采用植皮治疗的供区可直接缝合。使用传统的游离皮瓣预扩张技术，钝性分离可能有损伤蒂部的风险。使用球囊剥离器可通过无血管的筋膜间隙快速创建一个大的光学腔。这允许对光学腔进行内镜探查并确认组织扩张器的放置位置。此外，球囊辅助内镜下组织扩张器置入可优化皮肤拉伸的滞后效应，并提供即时液体注入的可能性，这最终缩短了显微外科转移前游离皮瓣扩张的时间。
