Complications in Tissue Expansion: An Updated Retrospective Analysis of Risk Factors

J. Wang; X. Huang; K. Liu; B. Gu; Q. Li

doi:10.1055/s-0034-1367000

Handchirurgie · Mikrochirurgie · Plastische Chirurgie, Inhaltsverzeichnis

Handchir Mikrochir Plast Chir 2014; 46(02): 74-79
DOI: 10.1055/s-0034-1367000

Original Article

Complications in Tissue Expansion: An Updated Retrospective Analysis of Risk Factors

Komplikationen in der Gewebeexpansion: Eine aktualisierte retrospektive Analyse der Risikofaktoren

J. Wang

¹Department of Plastic and Reconstructive Surgery, Shanghai 9th People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China

,

X. Huang

¹Department of Plastic and Reconstructive Surgery, Shanghai 9th People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China

,

K. Liu

¹Department of Plastic and Reconstructive Surgery, Shanghai 9th People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China

,

B. Gu

¹Department of Plastic and Reconstructive Surgery, Shanghai 9th People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China

,

Q. Li

¹Department of Plastic and Reconstructive Surgery, Shanghai 9th People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China

› Institutsangaben

Abstract

Background:

The technique of tissue expansion has been widely applied in plastic surgery since the 1980 s. Implantation in the lower limb region, external port placement, and young patient age were known as risk factors for complications. Over the years, surgical experience has increased along with improved patient management and expander manufacturing. The aim of this study was to identify possible changes in risk factors regarding complications in tissue expansion.

Method:

A retrospective, single-institution large sample observational study over a 5-year period (2006–2010) was performed involving 481 tissue expanders in 344 patients. Patients underwent surgical treatment for resurfacing scar tissue in the scalp, face, neck, nose, and limbs, but not breast. In addition, the results are discussed based on a comprehensive review of the literature published between 1995 and 2009.

Results:

Statistical analysis showed significant correlations between cheek and hematoma (P=0.0133), scalp and dehiscence (P=0.0139), number of expanders per region and leakage (P=0.0379), number of expanders per region and overall complications (P=0.0252). Factors such as gender, age, tobacco use, and repeated expander implantation had no significant influence on the incidence of complications. The lower extremity region and young patient age ceased to show a statistical correlation with complications. The number of expanders per region was identified as a risk factor that has been disregarded so far.

Conclusion:

Evidence suggests a recent change in risk factors for tissue expansion-related complications. Consideration of updated risk factors may help to further improve outcomes in tissue expansion.

Zusammenfassung

Hintergrund:

Die Technik der Gewebeexpansion findet seit den 1980er Jahren in der Plastischen Chirurgie breite Anwendung. Implantation in der unteren Extremitätenregion, externe Portplatzierung und junges Patientenalter sind als Risikofaktoren für Komplikationen bekannt. Mit dem Gewinn an chirurgischer Erfahrung sind im Laufe der Jahre auch Verbesserungen in Patientenmanagement und Expanderherstellung einhergegangen. Das Ziel dieser Studie war es, mögliche Veränderungen hinsichtlich Risikofaktoren für Komplikationen in der Gewebeexpansion zu identifizieren.

Methode:

In einer retrospektiven monozentrischen Beobachtungsstudie wurden über einen Zeitraum von 5 Jahren (2006–2010) 481 Gewebeexpander bei 344 Patienten untersucht. Die Patienten wurden wegen oberflächlicher Narben im Bereich von Skalp, Gesicht, Hals, Nase und Extremitäten exklusive Mammae chirurgisch behandelt. Des Weiteren wurde eine umfassende Literaturrecherche von Publikationen aus den Jahren 1995–2009 durchgeführt.

Ergebnisse:

Die statistische Analyse zeigte eine signifikante Korrelation zwischen Wange und Hämatom (P=0,0133), Skalp und Dehiszenz (P=0,0139), Anzahl der Expander pro Region und Leckage (P=0,0379) und Anzahl der Expander pro Region und Gesamtkomplikationen (P=0,0252). Faktoren wie Geschlecht, Alter, Tabakkonsum und wiederholte Expanderimplantation hatten keinen signifikanten Einfluss auf das Auftreten von Komplikationen. Die untere Extremitätenregion und junges Patientenalter wies keine statistische Korrelation mit Komplikationen mehr auf. Die Anzahl der Expander pro Region konnte als Risikofaktor identifiziert werden, der bislang nicht berücksichtigt wurde.

Zusammenfassung:

Die Resultate der vorliegenden Studie deuten auf veränderte Risikofaktoren für Komplikationen bei Gewebeexpansion hin. Die Berücksichtigung dieser aktuellen Risikofaktoren kann dazu beitragen, die Ergebnisse in der Gewebeexpansion weiter zu verbessern.

Key words

tissue expansion - complications - risk factors - reconstruction - expander

Schlüsselwörter

Gewebeexpansion - Komplikationen - Risikofaktoren - Rekonstruktion - Expander

Volltext

Referenzen

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