Background Soft-tissue deficiencies pose a challenge in a variety of disease processes when the end result is exposure of underlying tissue. Although multiple surgical techniques exist, the transposition of tissue from one location to another can cause donor-site morbidity, long incisions prone to dehiscence, and poor patient outcomes as a result. Use of tissue expansion prior to grafting procedures has been shown to have success in increasing available soft tissue to aid in repairing wounds. However, the current tissue expanders have biomechanical limits to the extent and rate of expansion that usually exceeds the tissue capacity, leading to incisional dehiscence or expander extrusion. Understanding the baseline biomechanical properties of the tissue to be expanded would provide useful information regarding surgical protocol employed for a given anatomical location. Therefore, the aim of this study was to test and compare the baseline (preexpansion) biomechanical properties of different common expansion sites in dogs. Methods Four samples measuring approximately 20 × 15 × 1 mm were harvested from 8 dogs. The samples were collected from the hard palate, alveolar mucosa, scalp, and chest of the animal and analyzed for stress, strain, maximum tangential stiffness, maximum tangential modulus, and tensile strength using a Texture Technologies TA.XT texture analyzer with corresponding biomechanical measurement software. Samples were compared as to their baseline biomechanical properties prior to any soft-tissue expansion. Histological sections of the samples were analyzed using hematoxylin eosin in an attempt to correlate the histological description to the biomechanical properties seen during testing. Summary statistics (mean, standard deviation, standard error, range) are reported for stress, strain, maximum tangential stiffness, maximum tangential modulus, and tensile strength and for the histological parameters by intraoral site. Analysis of variance was used to compare the biomechanical and histological parameters among the 4 locations while accounting for multiple measurements from each dog. Results The scalp had significantly higher maximum stress (σmax) than chest, mucosa, and palate (P 0.63). Scalp site also had significantly higher maximum tangential modulus (e) than chest, mucosa, and palate (P 0.17). The locations did not have significantly different maximum tangential stiffness (k; P = 0.72). Histologically, 2 separate patterns of collagen disruption were evident. Conclusion Although different results were obtained than theorized, this study showed that the scalp had the greatest resiliency to expand prior to tearing, and the highest tangential modulus, with all sites having statistically similar modulus of elasticity. Based on this study, the scalp could be expanded more aggressively compared with the other sites.

Baseline Biomechanical Properties of Epithelia prior to Tissue Expansion in Dogs.

Resume Objectif Presentant des contraintes et un risque de complication, l’expansion cutanee pour sequelles de brulure pediatrique necessite une technique operatoire maitrisee, et un programme chirurgical adapte aux particularites de cicatrisation, croissance et developpement de l’enfant. Materiel et methodes Nos principes de prise en charge et nos points techniques sont decrits. Une serie retrospective des expansions cutanee pour sequelles de brulure avant 18 ans entre 2005 et 2016 est presentee. Resultats La serie comptait 41 enfants, 98 protocoles et 185 protheses, avec plus de la moitie des sequelles au scalp cou ou thorax. L’âge moyen a la premiere expansion etait de 10,3 ans (5,8 ans post-brulure). En moyenne, 2,4 (1–8) protocoles etaient realises par patient, avec 1,9 (1–4) prothese par seance. La reconstruction etait un lambeau (78,8 %), une greffe de peau totale (13,3 %) ou l’association des deux. Les complications de l’expansion concernaient 15 patients, 30 protheses (14,6 %), et 22 protocoles (22,4 %), majoritairement des infections et expositions. Les complications de la reconstruction concernaient 8 patients, 14 protheses (7,6 %), et 10 protocoles (10,2 %). L’augmentation de la surface brulee etait significativement facteur de risque de complication. Le taux de protheses compliquees par localisation etait de 7,9 % (scalp), 12,5 % (cou), 9,8 % (sus-claviculaire), 10,5 % (thorax), 19,4 % (abdomen), 30 % (fesse), 29,4 % (membre inferieur), 1/2 (face). Conclusion L’expansion cutanee pour sequelles de brulure pediatrique etait optimale au scalp, favorable au tronc, au cou, et au membre superieur proximal, et a realiser avec prudence et reflexion au membre inferieur et a la face.

Expansion cutanée pour séquelles de brûlure de l’enfant. Principes de prise en charge et étude rétrospective de 42 patients sur 11 ans

Resume Objectifs L’expansion cutanee est un outil cle dans l’arsenal therapeutique propose pour la reparation des pertes de substances de l’extremite cephalique. Cette technique aussi interessante soit-elle est non demunie de risques. Le but de ce travail est l’identification des differents maillons de la procedure d’expansion cutanee, de determiner les facteurs a risque de complications inherents a chaque phase de l’expansion afin d’optimiser les resultats fonctionnels et esthetiques. Patients et methodes Nous avons realise une etude retrospective sur l’expansion de l’extremite cephalique sur une periode de 10 ans s’etalant de janvier 2009 a decembre 2018 avec au moins un an de suivi pour chaque patient. Notre etude a compte la pose de 98 protheses chez 63 patients, nous avons tenu compte des differentes variables qui interviennent dans le processus d’expansion afin de determiner celles qui augmentent le risque de complications. Resultats Dans notre serie nous avons compte 66,3 % de complications et 22,4 % d’echec. Nous avons trouve qu’un jeune âge a expose a un plus grand risque de souffrance cutanee, que le tabac a celui de la survenue d’hematome. L’expansion cervicale est la plus pourvoyeuse de complications suivie du scalp qui augmente le risque d’exposition surtout au niveau parietal. La face a ete retrouvee comme un site favorable a l’expansion. Nous avons trouve qu’il avait moins de risque pour une expansion multiple dans le meme temps operatoire plutot que les expansions iteratives et le choix de protheses volumineuses. Conclusion L’expansion au niveau de l’extremite cephalique necessite une planification rigoureuse en tenant compte de ses differents intervenants.

Complications de l’expansion cutanée cervico faciale : agir sur les facteurs modifiables. Étude sur 98 prothèses

The treatment of sequelae for burns or other loss of perioral tissues is complex due to the site where they occur, its functional importance, and social and esthetic aspects. Functional consequences of burns to this area are cutaneous retraction and a lack of skin that can lead to an inability to close the oral aperture, compromising the provision of dental hygiene and intubation procedures. The aim of the present publication was to evaluate the efficacy of chin, labial and jugal cutaneous expansions for the treatment of perioral lesions and lesions of the lower half of the face in our retrospective series of patients. We collected data and photography from digital files for each patient. Proportion of scarred skin that could be treated by one or several expansion procedures was evaluated. The main outcome was the resection of 50% or more initial lesions. Side effects were assessed. Out of a total of 33 expanders, 28 were at the jugal level, 5 were chin expanders, and none were labial expanders. This equated to the inclusion of fourteen patients. The average percentage of the lesion that was removed after the perioral expansion protocol was 68.9% (40%-100%). 85% of patients had a positive outcome. 12% of procedures were complicated by hematoma, infection or prosthesis exposure. Each time that the lesional area could be fully (i.e. 100%) treated, only a single expansion was used. Head and neck expansion is the technique of choice for reconstruction of the lower half of the face and the horizontal part of the neck in terms of efficiency and safety.

Head and neck skin expansion: assessment of efficiency for the treatment of lesions in the lower half of the face.

Resume But de l’etude/objectif Devant la difficulte majeure a prendre en charge les omphaloceles geantes dans la reintegration viscerale et la fermeture parietale, beaucoup d’equipes se tournent actuellement vers les techniques de tannage. Ces dernieres sont pourvoyeuses d’une eventration couverte et de sequelle cicatricielle necessitant une prise en charge a distance. Nous rapportons la place de l’expansion cutanee comme complement de traitement. Patients et methodes Deux patients nes avec une omphalocele geante ont beneficie d’un protocole d’expansion cutanee pour la correction de leur placard cicatriciel abdominal ± de leur eventration residuelle. Resultats Une fermeture de l’eventration a ete possible grâce a ce protocole. L’expansion cutanee a permis l’exerese complete du placard cicatriciel et la couverture du defect. Une greffe cutanee complementaire a ete necessaire dans le premier cas. Conclusion L’expansion cutanee dans la prise en charge des sequelles parietales des omphaloceles geantes parait une alternative interessante. Cette derniere doit se realiser a distance et en dehors de tout contexte septique.

Place de l’expansion cutanée dans le traitement des séquelles pariétales des omphalocèles géantes

The expansion of soft tissue, especially skin, is an old and physiological process to increase the skin reserve allowing excision while coveraging of the resulting loss of substance. Easy in principle, this process is subjected to constraints in children requiring precise planning and rigorous technical procedure. Between 1990 and 2016, we performed 293 expansion protocols with 411 implants in 244 children. The scalp was the most interested area (158 cases), followed by the trunk (29). The congenital nevi represented the most frequent indication (119 cases), followed by sequelae of burns and scars (64 cases) and hamartoma sebaceous of Jadassohn (27 cases). Three categories of indication can be established. Ideal indications of the expansion are on the scalp, skin preparation prior to the excision of a large nevus, nevus sebaceous of Jadhasson and severe breast hypoplasia. Common but delicate indications are scars, especially after burns, treatment of vertex aplasia cutis congenita and expansions of the limbs, abdomen, head and neck. Rare indications include separation of Siamese twins, or protection of the bowel before radiotherapy. Contra-indications are infected lesions, malignant tumors and lesions requiring immediate coverage. If the principle of expansion is relatively simple, its positioning on the scale of reconstruction methods is harder because of the risk of significant complications.

Indications of the expansion in pediatric surgery. Experience of 30years and literature review

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

A Capon

Author Tools

Chat about Author

Papers

Indications of the expansion in pediatric surgery. Experience of 30years and literature review