Complications using tissue expanders in burn sequelae treatment at a reference university hospital: a retrospective study.

Luiz Philipe Molina Vana,Hugo Alberto Nakamoto,João Paulo Fontana Bragagnollo,Rolf Gemperli,Carlos Fontana,Cristiane Pereira Lopes,Rodolfo Costa Lobato

doi:10.1590/0100-6991e-20202662

Luiz Philipe Molina Vana, Hugo Alberto Nakamoto + Show 5 more

Open Access

https://doi.org/10.1590/0100-6991e-20202662

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Abstract

tissue expanders have high relevance in plastic surgery and among indications it is worth mentioning their use in the treatment of burn reconstruction. Although it shows good results, its use requires special care because some complications can interrupt the reconstruction process. The objective of this study was to report the experience of the Clinics Hospital (University of Sao Paulo) with the use of tissue expanders to treat burn sequelae, establishing the incidence of complications, and identifying risk factors for their occurrence. a retrospective, observational, and analytical study, evaluating the use of expanders in burns sequelae treatment from 2009 to 2018. 245 expanders were placed in 84 patients, 215 were female, with a mean age of 19.96 years, being 40% in the trunk and 20% in the scalp, with a predominance of rectangular shape in 76.7% of cases. Complications were classified as major and minor.Complications occurred in 17.95% of cases, and extrusion and infection were the most common. There was a higher incidence of complications in expanders used in the upper and lower limbs as well as in those who did not undergo concomitant expansion (p <0.05), with an even higher chance of major complications in patients submitted to additional expansion. From 2009 to 2018, we observed a decrease in the incidence of complications. the complication rate (17.95%) is similar to other studies of the literature, there was a higher rate of complication with expanders placed in the limbs and a higher rate of major complications when additional expansion was done.

Highlights

In the last 30 years, tissue expansion has become a wellestablished reconstruction modality to treat soft tissue defects[1,2,3]
From January 2009 to December 2018, 245 tissue expanders were placed in 84 patients who had undergone burn sequelae treatment. 215 (87.75%) were placed in females and 30 (12.24%) in males
Tissue expanders have been used by the Department of Plastic Surgery and Burns at the Hospital das Clínicas, University of São Paulo, since 198411-13

Summary

Introduction

In the last 30 years, tissue expansion has become a wellestablished reconstruction modality to treat soft tissue defects[1,2,3]. Some authors claim that these complications are more related to its use in children, in the lower limbs, in previously expanded areas and in patients with burn sequelae, and infection and extrusion are the most common complications[4,6,7,8,9,10]. These facts lead some surgeons to try avoiding the use of expanders, especially those who do not have such experience with them[8,9,10].

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