The Role of Tissue Expansion for Head and Neck Reconstruction at Ramathibodi Hospital
Abstract
The technique of tissue expansion especially for head and neck reconstruction has been successfully used at Ramathibodi Hospital. During 1987-1999, there were 28 patients, 10 males and 18 females. Ages ranged from 7-43 years. New expanders were used in 8 patients, reused expanders by autoclaving sterilization were used in 18 patients, and two patients underwent tissue expansion by using Foley's catheter. Five patients underwent reexpansion while two patients underwent immediately reexpansion procedures and three procedures were carried out few weeks later. The most common tissue expanders used were rectangular shape of different sizes. There were minor complications including two minor wound infections which responded well to antibiotic therapy, two partial wound disruptions with exposure without extrusion of the expanders, one partial erosion of skin over the reservoir, one perforation of the expander by a needle during saline instillation, and one partial skin flap necrosis. Only the 25-gauge needles were used for instillation of saline through the ports and there was no port (reservoir) failure. Despite those minor complications, the overall post operative results were satisfactory. The skin or scalp defect can be replaced with skin flap or scalp flap respectively of identical color, texture, and appendages including hair growth.
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