Early application of tissue expansion in repair of traumatic soft tissue defects in the head and face

Abstract

Objective To explore a novel strategy to repair traumatic soft tissue defects in the head and face by tissue expansion in the early stage. Methods Eighteen patients with traumatic soft tissue defects were treated with thorough debridement leaving the wound unclosed or simply closed with thin split-thickness scalp skin grafting, and adjacent expander implantation in the early stage and expanded flap transposition in the second stage. Results There were 11 male patients and 7 female patients ranging in age from 3.5 to 40 years [mean, (19.4±12.2) years], with average 15 months follow-up (range, 3-67 months). The average expansion time was 74.3 days (range, 53-96 days). The total of 18 patients with 22 expanders were treated with satisfactory results. All the flaps survived and the skin color, texture and contour well matched to those of the peripheral tissue. Only one complication of infection happened in the 18 cases (5.56%) and total 22 expanders (4.55%), which was similar to the rate reported in the literature. There were no any other complications related to the expander. Conclusions Debridement and tissue expansion in the early stage have been proved a more effective strategy to repair traumatic soft tissue defects in the head and face, which can not only achieve satisfactory color, unbulky and well matched texture similar to normal, but also can avoid unnecessary donor site injuries and does not increase the infection rate of tissue expansion. Key words: Soft tissue defects; Tissue expansion; Head and face; Trauma