Use of overinflated tissue expanders in the surgical repair of head and neck scars

Abstract

Successful inflation of a tissue expander (TE) and coverage of the face with tissue of similar colour and texture is usually limited by the amount of skin generated during the reconstruction process. Overexpanding the TE device generates an increased flap size and an overall better reconstructive outcome. A total of 86 TEs were inserted into 48 burn patients with head and neck burn scars. In each case, a TE was inserted with subsequent overexpansion to 2-4 times the manufacturer's stated maximum volume. Using the above technique, we gained more transferable skin, which was then used to cover the defects. The rates of major and minor complications were the same as those obtained in previous studies. Illustrations of several representative cases are also included. Overinflation of smaller TEs minimises complication rates typically associated with this procedure. Cutaneous overexpansion can usually achieve the desired flap dimensions by overinflation of the implant well beyond the manufacturer's stated maximum volume, thus ensuring its success and allowing for better coverage of the defects.