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A Single Center Study of Tissue Expansion in Burn Reconstruction: Assessment of Surgical Outcomes
Tiffany Jeong, Avril Betances, Mario Alessandri-Bonetti, Guy M Stofman, Francesco M Egro
UPMC
2023-02-01
Presenter: Avril Betances
Affidavit:
Avril had a major part in creating the groundwork and execution of this project. From database to final study.
Director Name: Guy M Stofman
Author Category: Other Specialty Resident
Presentation Category: Clinical
Abstract Category: General Reconstruction
Background
Tissue expansion is an alternative for improved aesthetic and function of chronic burn scars. Few studies have reported outcomes and complication rates associated with this method. Our study aims to report a 13-year experience at a single center institution for correction of chronic burn sequelae with tissue expansion.
Methods
A retrospective review was performed where demographics, burn etiology, expander-related characteristics and postoperative complications were collected for patients between January 2009 and December 2022.
Results
Of the 901 patients treated for burns by plastic surgery, 9 underwent tissue expansion for scar sequelae. The mean time from initial injury was 18.2ą10.8 months. In total, 66.7% patients were male, and 33.3% female with a mean age of 36.0ą18.8 years at time of operation. A total of 30 tissue expanders were placed at 22 unique anatomical sites. Expanders were placed with the intention of addressing burn scar alopecia (70%, n=21), performing adjacent tissue transfer (16.7%, n=5) and full thickness skin graft (13.3%, n=4). The expanders ranged from 65 cc to 1600 cc in size. On average, being filled to 48.0%ą36.7% of their capacity before removal. The overall complication rate was 46.7%(n=14), including major complications, extrusion (23.3%, n=7) and infection (6.7%, n=2), and minor complications, erythema (23.3%, n=7), discharge (13.3%, n=4), and edema (6.7%, n=2). Mean follow-up period was 43.3ą32.2 months.
Conclusion
Tissue expansion is a workhorse treatment for scar revision in cases of local tissue deficiency. In burn patients, a high rate of complications was experienced. Further strategies are needed to minimize complications.
