Salvaging the Unavoidable: A Review of Complications in Pediatric Tissue Expansion.

Abstract:

BACKGROUND:Tissue expansion, while a mainstay of reconstruction for pediatric cutaneous lesions, has significant complication rates. The authors review the complications in a single-surgeon series of tissue expansion to identify risk factors for complications and guide subsequent therapy so that reconstructive goals in patients can be met irrespective of intervening complications. METHODS:A retrospective chart review was conducted of all pediatric patients who underwent tissue expansion performed by the senior author (A.K.G.) over a 12-year period. In total, 282 expanders were placed in 94 patients. RESULTS:A total of 65 complications occurred in 39 of 94 patients (41.5 percent), involving 65 of the 282 expanders (23.0 percent) placed. Major complications that required expander removal included exposure (n = 11), rupture (n = 15), and migration (n = 11). The most frequent minor complications, which did not require immediate expander removal, included migration (n = 13) and port malfunction (n = 9). The majority of expanders were placed in the scalp (n = 114), followed by the torso (n = 100), face and neck (n = 52), and the extremities (n = 16). Serial expansion beyond the second round resulted in a marked increase in complications. Despite complications, tissue expansion in the majority of patients could be salvaged, and a satisfactory outcome was achieved. CONCLUSIONS:Families must be made aware that approximately one-third of patients may have a complication requiring additional surgery or modification of the initial reconstructive plan. However, these complications need not preclude attainment of reconstructive goals. CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic, IV.

journal_name

Plast Reconstr Surg

authors

Gosain AK,Turin SY,Chim H,LoGiudice JA

doi

10.1097/PRS.0000000000004650

subject

Has Abstract

pub_date

2018-09-01 00:00:00

pages

759-768

issue

3

eissn

0032-1052

issn

1529-4242

pii

00006534-201809000-00035

journal_volume

142

pub_type

杂志文章
  • Suction curettage to remove excess fat for body contouring.

    abstract::We have significantly expanded the use of a lipectomy procedure which heretofore had been restricted to the removal of strictly localized excess fat deposits by curettage through a small incision. By modifying the suction curette and utilizing it for extensive body contouring, we have been successful in correcting rel...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198107000-00012

    authors: Teimourian B,Fisher JB

    更新日期:1981-07-01 00:00:00

  • Painless abdominoplasty: the efficacy of combined intercostal and pararectus blocks in reducing postoperative pain and recovery time.

    abstract:BACKGROUND:Reducing postoperative pain following abdominoplasty is essential for shortening the length of recovery time, reducing the use of narcotics, promoting quicker return to normal activities, and maximizing overall patient satisfaction. The extended use of narcotics and pain pumps is often unacceptable because o...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e3181ef8fe5

    authors: Feng LJ

    更新日期:2010-11-01 00:00:00

  • Effects of an autologous flap combined with an implant for breast reconstruction: an evaluation of 1000 consecutive reconstructions of previously irradiated breasts.

    abstract:BACKGROUND:The goal of the authors' study was to determine whether an autologous tissue flap, when combined with an implant for breast reconstruction, reduces the incidence of implant-related complications in previously irradiated breasts. METHODS:The authors reviewed 1000 consecutive cases of implant-based breast rec...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e31817d6303

    authors: Chang DW,Barnea Y,Robb GL

    更新日期:2008-08-01 00:00:00

  • Functional return of tendon graft protected entirely by pseudosheath--experimental study.

    abstract::Sixty-three white Leghorn chickens were used in a two-stage tendon grafting into the deep flexor of the third toe. In the first stage, a 4- or 8-week-old pseudosheath was created around the Silastic rod. In the second stage, the grafting was carried out: in 33 birds the new sheath covered the entire tendon graft and i...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198002000-00011

    authors: Farkas LG,Lindsay WK

    更新日期:1980-02-01 00:00:00

  • Nonsurgical Rhinoplasty: A Systematic Review of Technique, Outcomes, and Complications.

    abstract:BACKGROUND:Nonsurgical rhinoplasty using filler injections has become a common procedure in cosmetic practices. This is offered to patients that prefer a temporary outcome or would like to avoid general anesthesia. In addition, it can be used in postrhinoplasty patients to correct nasal deformities or irregularities. T...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000006892

    authors: Williams LC,Kidwai SM,Mehta K,Kamel G,Tepper OM,Rosenberg JD

    更新日期:2020-07-01 00:00:00

  • Postoperative Ketorolac in Breast and Body Contouring Procedures: A Nationwide Claims Analysis.

    abstract:BACKGROUND:Nonsteroidal antiinflammatory drugs are useful alternatives to narcotics for analgesia. However, concerns remain regarding their safety. The authors evaluated ketorolac use and complications. We hypothesized that no association between ketorolac and morbidity exists in patients undergoing body contouring. M...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000004806

    authors: Kelley BP,Chung KC,Chung TT,Bennett KG,Sacks G,Sears ED,Waljee JF

    更新日期:2018-10-01 00:00:00

  • The extensor digitorum brevis muscle island flap for soft-tissue loss around the ankle.

    abstract::The extensor digitorum brevis muscle flap, which has already been suggested as a local flap for the foot, has been applied by us in 2 cases with excellent results. This flap, as with other muscle flaps, provides an excellent bed for the skin graft. Furthermore, because of its width, it allows for covering an area of s...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198506000-00024

    authors: Landi A,Soragni O,Monteleone M

    更新日期:1985-06-01 00:00:00

  • Inhibition of fibroblast-populated collagen lattice contraction by an albumin-bound lipid fraction in human amniotic fluid.

    abstract::Human amniotic fluid inhibits the contraction of fibroblast-populated collagen lattices. Amniotic fluid of 21 weeks' gestation was previously reported to have peak inhibiting activity. An attempt to isolate the inhibitory factor(s) from human amniotic fluid employing a molecular sieving column demonstrated an inhibito...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199801000-00002

    authors: Yager JS,Hugo NE,Ehrlich HP

    更新日期:1998-01-01 00:00:00

  • A rapid in vitro assay of cellular chemomigration in an epithelial carcinoma cell line.

    abstract::We have studied the chemomigration activity of an epithelial carcinoma cell line using a modified 96-well Boyden chamber apparatus consisting of upper and lower wells separated by an 8-microns pore polycarbonate filter. Cells from the malignant squamous carcinoma cell line A-431 were plated in the upper wells over a c...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199512000-00024

    authors: Ricciardelli EJ,Persing JA,Romano JA,Morgan RF,Ogle RC

    更新日期:1995-12-01 00:00:00

  • Heterotopic Procedures in Mutilating Hand Injuries: A Synopsis of Essential Reconstructive Tools.

    abstract:BACKGROUND:In the complex and challenging treatment of a mutilating hand injury, any available resources need to be primarily recruited. Besides direct digital replantation, the tissue of the nonreplantable "spare parts" could often be "recycled," and also some replantable or injured structures could be "redistributed"...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000001721

    authors: Kokkoli E,Spyropoulou GA,Shih HS,Feng GM,Jeng SF

    更新日期:2015-11-01 00:00:00

  • Analysis of the effects of deep mechanical massage in the porcine model.

    abstract::Deep mechanical massage has been advocated as an alternative or adjunctive therapy for the contouring of subcutaneous fat and as a treatment for cellulite. We evaluated the effects of deep mechanical massage using two pig models. Yucatan pigs were divided into three groups (n = 4). One side of each body received 4, 10...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-200107000-00038

    authors: Adcock D,Paulsen S,Jabour K,Davis S,Nanney LB,Shack RB

    更新日期:2001-07-01 00:00:00

  • Acute hand compartment syndromes after closed crush: a reappraisal.

    abstract::Severe crush to the hand is associated with a poor prognosis. The authors investigated the hypothesis that compartment syndrome complicates such injuries. From 1996 to 2000, the authors retrospectively identified 11 patients who, after sustaining a closed crush injury, developed acute hand compartment syndrome. Diagno...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.PRS.0000025183.78057.9B

    authors: Del Piñal F,Herrero F,Jado E,García-Bernal FJ,Cerezal L

    更新日期:2002-10-01 00:00:00

  • Quality of life long-term after body contouring surgery following bariatric surgery: sustained improvement after 7 years.

    abstract:BACKGROUND:Bariatric surgery for morbid obesity results in massive weight loss and improvement of health and quality of life. A downside of the major weight loss is the excess of overstretched skin, which may influence the patient's quality of life by causing functional and aesthetic problems. The purpose of the curren...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e318267d51d

    authors: van der Beek ESJ,Geenen R,de Heer FAG,van der Molen ABM,van Ramshorst B

    更新日期:2012-11-01 00:00:00

  • Mesh lift: a new procedure for long-lasting results in brow lift surgery.

    abstract:BACKGROUND:Prevention of recurrent eyebrow ptosis is the greatest challenge in brow lift surgery today. In this article, the author describes a new surgical procedure to provide long-lasting results in brow lift surgery. METHODS:Over 7 years, this new technique was used in 37 patients. Except for four, all patients we...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000182601.94805.58

    authors: Mutaf M

    更新日期:2005-10-01 00:00:00

  • The venous skin graft method for repairing skin defects of the fingers.

    abstract::A venous skin graft for the treatment of skin defects in a finger is described. This procedure involves taking a flap from the forearm together with the subcutaneous vein and anastomosing both ends of this vein to the digital artery and vein, respectively. Thirteen difficult finger wounds were resurfaced with such a v...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198702000-00016

    authors: Yoshimura M,Shimada T,Imura S,Shimamura K,Yamauchi S

    更新日期:1987-02-01 00:00:00

  • The impact of negative-pressure wound therapy with instillation compared with standard negative-pressure wound therapy: a retrospective, historical, cohort, controlled study.

    abstract:BACKGROUND:Negative-pressure wound therapy with instillation is a novel wound therapy that combines negative pressure with instillation of a topical solution. METHODS:This retrospective, historical, cohort-control study examined the impact of negative-pressure wound therapy with and without instillation. RESULTS:One ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/01.prs.0000438060.46290.7a

    authors: Kim PJ,Attinger CE,Steinberg JS,Evans KK,Powers KA,Hung RW,Smith JR,Rocha ZM,Lavery L

    更新日期:2014-03-01 00:00:00

  • Comparison of hemihypoglossal nerve versus masseteric nerve transpositions in the rehabilitation of short-term facial paralysis using the Facial Clima evaluating system.

    abstract:BACKGROUND:Masseteric and hypoglossal nerve transfers are reliable alternatives for reanimating short-term facial paralysis. To date, few studies exist in the literature comparing these techniques. This work presents a quantitative comparison of masseter-facial transposition versus hemihypoglossal facial transposition ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e318267d5e8

    authors: Hontanilla B,Marré D

    更新日期:2012-11-01 00:00:00

  • Development of a novel nonantigenic dermal implant composed of human placental collagen.

    abstract::Injectable bovine collagen has proven to be safe and effective for the treatment of contour defects for more than 20 years. After intradermal exposure to bovine collagen, the most commonly reported side effect is hypersensitivity (incidence of approximately 3 percent to test and approximately 1 to 2 percent to subsequ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1097/01.prs.0000105649.69434.ef

    authors: Toman PD,Egbert BM,Thomas JA,DeLustro FA

    更新日期:2004-03-01 00:00:00

  • Rapid three-dimensional measuring system for facial surface structure.

    abstract::A noncontact three-dimensional measuring system (liquid crystal range finder system) is described. Three-dimensional facial surface data (more than 30,000 points) could be obtained in 1 second, and the resolution was approximately 0.4 mm. The reliability and repeatability of the results were validated with a calibrati...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199811000-00046

    authors: Yamada T,Sugahara T,Mori Y,Sakuda M

    更新日期:1998-11-01 00:00:00

  • Speech intelligibility after partial glossectomy in children with Down's syndrome.

    abstract::Twenty-three children with Down's syndrome, aged between 3.7 and 17.5 years, underwent partial glossectomy for improvement of cosmetic appearance. Improved speech was also expected. Preoperative and postoperative audiotaped samples of spoken words and connected speech on a standardized articulation test were rated by ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198701000-00007

    authors: Margar-Bacal F,Witzel MA,Munro IR

    更新日期:1987-01-01 00:00:00

  • Guiding local perforator flaps with preoperative imaging: revealing perforator anatomy to improve flap design.

    abstract:BACKGROUND:Perforator flap nomenclature continues to evolve, with many classification schemes reported. Each of them focuses on the fascial penetration pattern of perforators, which has no impact on flap perfusion. With the advent of advanced imaging technologies, the subcutaneous course of perforators can be highlight...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e31824ecaff

    authors: Rozen WM,Paddle AM,Chubb D,Wilson J,Grinsell D,Ashton MW

    更新日期:2012-07-01 00:00:00

  • Late infection following aesthetic malar augmentation with proplast implants.

    abstract::Two cases of late infection following aesthetic malar augmentation with Proplast implants are described. The etiology appears to be contamination because of erosion of the implants through the thin wall of the anterior maxilla. This problem might be avoided by confining placement of the implant over the thick portion ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199502000-00021

    authors: Adams JR,Kawamoto HK

    更新日期:1995-02-01 00:00:00

  • Umbilical transposition in TRAM flap: a simple horizontal translocation.

    abstract::A simple method of umbilical repositioning by incising the anterior rectus sheath and rectus abdominis muscle is reported for cases of unilateral abdominal wall plication during the TRAM flap operation. This method keeps the umbilicus stable and nonstenotic, and it avoids hypertrophic scars, which result from other te...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199912000-00029

    authors: Raveh T,Gordon CB,del Campo AF

    更新日期:1999-12-01 00:00:00

  • Diagnostic pediatric computed tomographic scans of the head: actual dosage versus estimated risk.

    abstract:BACKGROUND:Recent publications have implicated computed tomographic scans in the genesis of cancer and developmental delay. To determine whether the imaging protocols used in the authors' craniofacial practice could be harmful, they reviewed patient radiation exposure data for 77 patients. They then reviewed the litera...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0b013e3181b59d2d

    authors: Jaffurs D,Denny A

    更新日期:2009-10-01 00:00:00

  • Shared medical appointments for preoperative evaluation of symptomatic macromastia.

    abstract:BACKGROUND:Shared medical appointments combine individual patient-physician encounters with a group educational segment. This allows for patients' needs to be addressed individually and for patients to benefit from shared learning. Shared medical appointments enhance knowledge, understanding, and management of disease ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000000750

    authors: Giladi AM,Brown DL,Alderman AK

    更新日期:2014-12-01 00:00:00

  • Development of articulation before delayed hard-palate closure in children with cleft palate: a cross-sectional study.

    abstract::The development of articulation before surgical closure of the hard palate was compared in 75 preschool children with cleft lip and palate and 40 preschool children born without clefts. The children were aged 2 years to 5 years 11 months. The patients had significantly poorer articulation skills than the controls at e...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198710000-00007

    authors: Noordhoff MS,Kuo J,Wang F,Huang H,Witzel MA

    更新日期:1987-10-01 00:00:00

  • A reliable method for monitoring the microvascular patency of free jejunal transfers in reconstructing the pharynx and cervical esophagus.

    abstract::Reconstruction of the pharynx and esophagus with revascularized segments of jejunum remains a time-proven entity. Most thromboses and subsequent flap failures have occurred within the first 24 hours after revascularization of the flap. What would therefore be desirable is a safe, proven monitoring system to assess the...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198905000-00024

    authors: Bafitis H,Stallings JO,Ban J

    更新日期:1989-05-01 00:00:00

  • Closure of the circular defect with double rotation flaps and Z-plasties.

    abstract::A method is presented for the closure of a circular defect without altering its shape. It employs semicircular rotational flaps and Z-plasties. Its use in 178 patients with malignant skin neoplasms is presented. ...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-198412000-00015

    authors: Golomb FM

    更新日期:1984-12-01 00:00:00

  • Proof of plasmatic imbibition in rat musculocutaneous grafts: enzymatic proof using peroxidase.

    abstract::At present, the concept of plasmatic imbibition is generally accepted. That is, observation of weight change or pigmentation methods of the grafts were established to support it. In the present study, we investigated plasmatic imbibition in rat musculocutaneous grafts histologically using peroxidase, which is one of t...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/00006534-199203000-00022

    authors: Fukui A,Maeda M,Tamai S,Inada Y

    更新日期:1992-03-01 00:00:00

  • Nationwide Cost Variation for Thumb Replantation: A Population Study.

    abstract:BACKGROUND:Health care reforms aimed at bundling payments attempt to contain costs. Uncovering variation in spending provides one strategy for decreasing expenditure. This study aims to investigate interhospital cost variation for thumb replantation. METHODS:A retrospective cross-sectional analysis of patients undergo...

    journal_title:Plastic and reconstructive surgery

    pub_type: 杂志文章

    doi:10.1097/PRS.0000000000006022

    authors: Billig JI,Zhong L,Chung KC

    更新日期:2019-10-01 00:00:00