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Use of tissue expanders in the repair of complex abdominal wall defects.

Abstract：

BACKGROUND/PURPOSE:Closure of abdominal wall defects in children poses a challenge for pediatric surgeons. We describe a technique using tissue expanders placed either intraperitoneally or in the abdominal wall to aid in the reconstruction of a variety of complex abdominal wall defects. METHODS:The tissue expanders are inserted under general anesthesia. Initial expansion is done in the operating room with attention to peak airway pressure, urine output, and end-tidal carbon dioxide. The expanders are inflated in the outpatient setting via percutaneous access until the calculated inflation volume is achieved. They are then removed; and definitive closure is accomplished using a combination of native tissue flaps, abdominal component separation techniques, biomaterials, and synthetic material. RESULTS:Six children underwent tissue expansion for treatment of abdominal wall defects (omphalocele, n = 3), trauma (n = 1), and thoracopagus twins (n = 1 pair). One to 4 expanders were used per patient, with all having a successful reconstruction of their abdominal walls. Two to 3 operations were required to restore abdominal domain and consisted of expander insertion, removal with reconstruction, and possible revision of the reconstruction. CONCLUSIONS:Tissue expanders possess a broad range of applications for abdominal wall reconstruction and can be used in patients of all ages.

journal_name

J Pediatr Surg

journal_title

Journal of pediatric surgery

authors

Clifton MS,Heiss KF,Keating JJ,Mackay G,Ricketts RR

doi

10.1016/j.jpedsurg.2010.11.020

subject

Has Abstract

pub_date

2011-02-01 00:00:00

pages

372-7

issue

2

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(10)01007-9

journal_volume

46

pub_type

杂志文章

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