Endoscopic Tissue Expander Implantation in Postburn Reconstruction: A Review of the Literature.

Abstract

Tissue expansion generates new tissue that can be used in postburn reconstruction. Expanders are placed through small incisions, requiring difficult and sometimes blind dissection to prepare an adequate pocket. Recently, the use of endoscopy to assist in expander placement has been described, which may improve intraoperative visualization and allow for a smaller incision. In this review, we summarize the existing literature on endoscopic tissue expander (TE) placement in postburn reconstruction and highlight areas for future research. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were utilized to conduct this review. The following databases were queried for the initial search of relevant articles: PubMed, Embase, Scopus, Cochrane, and Web of Science. The data were assessed qualitatively due to the heterogeneity in reporting between the studies. Our literature query yielded 1023 studies. Sixteen manuscripts underwent full-text review, and 7 met inclusion criteria. All studies demonstrated that the endoscopic approach led to successful tissue expansion. Four articles performed a comparative analysis between the open and endoscopic approach, all of which found a significant reduction in complications like seroma, hematoma formation, and device exposure with endoscopic TE implantation. Two studies demonstrated that the use of endoscopy significantly reduced operative time and length of stay. Endoscopy is a safe and effective tool in tissue expansion for postburn reconstruction. Further prospective research should include evaluating the cost-benefit of this approach and long-term outcomes for patients who have undergone endoscopic-assisted TE placement.