The Use of Foley Catheter for Immediate Intraoperative Tissue Expansion
Abstract
Background: The two-stage technique of tissue expansion is well-accepted modality for increasing available local skin flap with the same colour, texture, and sensation for defect closure. Immediate intraoperative tissue expansion with several stress-load cycles is a technique based upon the same principle of traditional chronic tissue expansion. The use of Foley catheter as a tissue expander for immediate intraoperative tissue expansion has been previously reported.
Objective: To demonstrate the use of Foley catheter for immediate intraoperative tissue expansion with only one stress-load cycle.
Materials and Methods: Twelve patients, ages ranged from 7-52 years, underwent immediate intraoperative tissue expansion for closure of small skin defect in which simple primary closure was not possible despite proper undermining. One to four 30 ml Foley catheters were used with one stress-load cycle of 20-40ml saline inflation. Six procedures were for scar revisions, five for closure of skin defects following removal of pigmented lesions (in five patients), one for closure of traumatic leg wound defect and one for lengthening of lower lip.
Results: All twelve skin defects were closed by the expanded skin flaps. Advancement flap was the most common flap (10/12) used for reconstruction. There were no skin necrosis, wound dehiscence or infection. The postoperative results were satisfactory including the lengthening of the lower lip. However, some patients needed scar revisions to obtain better aesthetic results.
Conclusions: The technique of using Foley catheter for immediate intraoperative tissue expansion with single stress-load cycle for 30 minutes is safe and can be performed easily under local anaesthesia. This is a nice technique for a surgeon to keep in mind.
References
2. Radovan C. Reconstruction of the breast after radical mastectomy using temporary expander (Letter), Plast Surg Forum 1980; 1: 41.
3. Radovan C. Breast reconstruction after mastectomy using the temporary expander. Plast Reconstr Surg 1982; 89:195-206.
4. Austad ED, Rose GL. A self-inflating tissue expander. Plast Reconstr Surg 1982; 70: 588-93.
5. Argenta LC. Reconstruction of the breast by tissue expansion. Clin Plast Surg 1984; 11: 257-64.
6. Manders EK, Schenden JJ, Furrey JA, et al. Soft-tissue expansion: concepts and complications. Plast Reconstr Surg 1984; 74: 493-507.
7. Argenta LC, Marks MW, Pasyk KA. Advances in tissue expansion. Clin Plast Surg 1985; 12: 159-71.
8. Cohen IK. Silicone expander with self-contained valve (Letter). Plast Reconstr Surg 1985; 74: 2.
9. Mackinnon SE, Gruss JS. Soft tissue expanders in upper limb surgery. J Hand Surg (Am) 1985;10: 749-53.
10. Morgan RF, Edgerton MT. Tissue expansion in reconstructive hand surgery: case report. J Hand Surg (Am) 1985; 10: 754-7.
11. Leonard AG, Small JO. Tissue expansion in the treatment of alopecia. Br J Plast Surg 1986; 39: 42-56.
12. Sellers DS, Millers SH, Demuth RJ. Tissue expansion as an adjunctive technique for the management of difficult wounds. Am J Surg 1986; 151: 603-6.
13. Becker H. Breast reconstruction using a permanent tissue expander. Plast Surg Forum 1986; 9: 20-34.
14. Versaci AD, Malkovich ME, Goldstein SA. Tissue expansion for congenital and burn deformities. Ann Plast Surg 1986; 16:20-31.
15. Austad ED. Complications in tissue expansion. Clin Plast Surg 1987; 14:549-50.
16. Hallock GG. Maximum over inflation of tissue expanders. Plast Reconstr Surg 1987; 80: 567-9.
17. Roenign RK, Wheeland RG. Tissue expansion in dermatologic surgery. Dermatol Clin 1987; 5: 429-36.
18. Manders EK, Oaks TE, Au VK, et al. Solft-tissue expansion in the lower extremities. Plast Reconstr Surg 1988; 81: 208-19.
19. Antonyshyn O, Gruss JS, Zuker R, et al. Tissue expansion in head and neck reconstruction, Plast Reconstr Surg 1988;82: 58-68,
20. Gibson T. Physical properties of skin. In: McCarthy JG, editor. Plastic surgery. Philadephia: WB Saunders Company; 1990. p. 207-20.
21. Sasaki GH. Intraoperative sustained limited expansion (ISLE) as an immediate reconstructive technique. Clin Plast Surg 1987;14:563-73.
22. Hirshowitz B, Kaufman T, Ullman J. Reconstruction of the tip of the nose and alar by load cycling of nasal skin and harnessing of extra skin. Plast Reconstr Surg 1986; 77: 316-9.
23. Stein HC. Foley catheter for immediate tissue expansion (Letter), Plast Reconstr Surg 1988;81: 990.
24. Kruavit A, Visuthkosol V. Tissue expansion. Paper presented at the 20th Scientific Annual Meeting of the Royal College of Surgeons of Thailand, July 1996, Pattaya, Thailand.
25. Kruavit A, Visuthikosol V, Technique of tissue expansion for head and neck reconstruction at Ramathibodi Hospital. Paper presented at the 23rd Scientific Annual Meeting of the Royal College of Surgeons of Thailand. July 2000, Pattaya, Thailand.
26. Kruavit A, Visuthikosol V. The role of tissue expansion for head and neck reconstruction at ramathibodi hospital. Thai J Surg 2001; 22: 51-60.
27. Kruavit A. The role of tissue expansion for correction of skin lesion. Thai J Cosmetic Dermatol Surg 2002; 3: 53-63.
28. Hirshowitz B, Jackson IT. An attempt to harness the viscoelastic properties of skin in face lift operations-a preliminary report. Ann Plast Surg 1987; 18:188-98.
29. Marks MW, Argenta LG, Thornton JW. Rapid expansion: experimental and clinical experience. Clin Plast Surg 1987;14:455-63.
30. Machida BK, Liu-Shindo M, Sasaki GH, et al. Immediate versus chronic tissue expansion. Ann Plast Surg 1991;26:227-32.
31. Gibson T, Kenedi RM, Craik JE. The mobile microarchitecture of dermal collagen: a bioengineering study. Br J Surg 1965;52:764.
32. Mackay DR, Saggers BS, Cotwald N, Manders EK. Stretching skin: undermining is more important than intraoperative expansion. Plast Recontr Surg 1990; 86:722-3.
33. Swanson NA, Argenta LC. In: Roenigk RK, Roenigk HH, editors. Dermatologic surgery: principles and practice. New York: Marcel Dekker; 1989. p. 347-54.
34. Greenbaum ss, Greenbaum CH. Intraoperative tissue expansion using a foley catheter following excision of a basal cell carcinoma. J Dermatol Surg Oncol 1990; 16: 45-8
35. Abramo AC, Viola JC, Angelo AJ. Intraoperative rapid expansion in cleft palate repair. Plast Reconstr Surg 1993; 91:441-5.
36. Carruthers A. Tissue expansion and mohs micrographic Surgery. J Dermatol Surg Oncol 1993; 19:1106-9.
37. Foster JA, Scheiner AJ, Wulc AE, et al. Intraoperative tissue expansion in eyelid reconstruction, Ophthalmology 1998; 105:170-5.8.
Downloads
Published
How to Cite
Issue
Section
License
Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.
