Second-generation self-inflating tissue expanders: a new dimension in tissue expansion

Abstract

Objective To study the different uses of second-generation self-inflating tissue expanders regarding the advantages, disadvantages, and the rate of complications. Background Tissue expansion is a valuable technique in soft-tissue reconstruction. Osmotic expanders are self-inflating and obviate the need for repeated injections. They eliminate port-site problems and reduce the potential to introduce infection. The use of such expanders has become more common in recent years. Patients and methods The study included two parts: retrospective part from January to June 2017 and prospective part from August 2017 till January 2019. The study included 40 patients, admitted to the Plastic Surgery at El-Menoufyia University Hospital and Prince Mohammad Bin Abdulaziz National Guard Hospital – Madinah in Saudi Arabia. The patients had post-burn scars, alopecia, and large nevi. A total of 69 second-generation self-inflating tissue expanders were implanted from January 2017 till January 2019, with a follow-up period of 12 months. Results Of the patients, 30 patients were females and 10 were males. The indication was large scar in 30 cases, alopecia in five cases, and giant nevus in five cases. Extrusion occurred in 10 (14.4%) expanders, which occurred in six (15%) patients. The highest percentage of extrusion occurred in the scalp, in which six of 10 expanders extruded. Conclusion The study indicates that self-inflating expanders can be safely and effectively used for various plastic and reconstructive procedures especially in children. The fact that numerous painful and distressing filling sessions are obviated with these expanders is particularly beneficial for those children too young to understand and cooperate. Moreover, this approach minimizes the risk of infection and lowers costs.