Abstract
Tissue expansion represents one of the major advances in surgery and is particularly applicable to burn reconstruction. The technique provides tissue of similar texture and color to the defect to be covered and has the added advantage of minimal donor site morbidity. This study aimed to assess the results & complications in the correction of post burn scalp alopecia using a tissue expansion, prevention of implant extrusion, lower the infection rate in tissue expansion and expander selection. Forty patients with scalp burn alopecia treated with tissue expansion of the scalp, were included in this prospective study in Sulaimania hospital of burn and reconstructive surgery from February 2002 to September 2009 with age groups ranging from (4-30) years with an average of 15.5 years. Twenty three patients were females. The time period between burn injury and reconstruction ranged between (4-25) years, their scalp defects ranging between (5x10cm -13x25cm). We were able to completely reconstruct 77.5% of the total patients with single or multiple sessions of expansions. The remaining 22.5% patients have benefited from reduction in the percentage of alopecia and recreation of anterior hair line to camouflage their defects. Major complications occurred in 6 cases(15%), in which the expansion process interrupted with removal of the expander. In conclusion, It is not always possible to measure the absolute efficacy of a surgical technique or determine a general guideline its indication of the tissue expansion procedure although afflicted with a broad range of possible complications, the tissue expansion procedure remains a valuable and reliable technique for the reconstruction of post burn alopecia of the scalp.
Highlights
Scalp burn alopecia is a healed burn scar resulting in permanent destruction of hair follicles and irreversible hair loss
Patients and methods Forty patients with scalp burn alopecia treated with tissue expansion of the scalp, were included in this prospective study in Sulaimania hospital of burn and reconstructive surgery from February 2002 to September 2009 with age groups ranging from (4-30) years with an average of 15.5 years, 23 patients were females
Rotational scalp flaps, and on rare occasions, free hair follicle transplantation or micro vascular scalp transfers have been found to be effective in attaining this objective, they may present problems of excessive blood loss, lengthy hospital stays and scalp flap necrosis[6,12]
Summary
Scalp burn alopecia is a healed burn scar resulting in permanent destruction of hair follicles and irreversible hair loss. The technique provides tissue of similar texture and color to the defect to be covered and has the added advantage of minimal donor site morbidity, the only sequel of tissue expansion should be the scar It does have the disadvantage of being a two stage procedure, and requiring multiple hospital visits, in addition to the discomfort and period of increased deformity during the period of scalp expansion. Another of the great advantages of tissue expansion is the massive increased in vascularity of the expanded tissue. Stress relaxation: as tissue stretches it relaxes and less force is required to maintain it stretched
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