소아 환자에서 조직확장기 사용의 유용성 = Usefulness of using Tissue Expander in Pediatric Patient

다국어 초록 (Multilingual Abstract)

Purpose: Reconstruction of soft tissue defect using tissue expander can provide better flap which is more similar to surrounding tissue in color, skin texture and hair compared to other methods. Many pediatric patients need reconstruction of soft tissue defect because of giant congenital nevi, congenital or acquired malformations and burn scars. Reconstruction using tissue expander is adequate to minimize dysmorphism in these patients. We intended to assess outcomes of using tissue expander in pediatric patients by retrospective study. Methods: Total cases were 168 of pediatric patients who received soft tissue reconstruction using tissue expander by the same surgeon from February, 1982 to May, 2009. All patients who received soft tissue reconstruction were under 10 years old. Mean age was 4.3 years old, the youngest 13 months, the oldest 8 years. Eightynine cases were male and 79 cases were female. Most common cause was giant hairy nevi (67 cases, 39.9%), secondary cause was burn scar/scar contracture (61 cases, 36.3%). Trunk (38 cases, 22.6%) was most common anatomical location. Results: Soft tissue defects were successfully covered using tissue expander in 149 cases (88.7%) without major complications. There was infection on 8 cases (4.7%) and we treated by adequate antibiotics in these cases. There were tissue expander folding or valve displacement on 5 cases (3%). Conclusion: Usage of tissue expander is useful on pediatric patients because tissue expansion is rapid on children and there are less secondary contractures on operation site than full thickness skin graft. Because of psychological stress due to tissue expander, operation should be performed before school age.

참고문헌 (Reference)

1 Iconomou TG, "Tissue expansion in the pediatric patient" 31 (31): 134-, 1993

2 Radovan C, "Tissue expansion in soft-tissue reconstruction" 74 : 482-, 1984

3 Versaci AD, "Tissue expansion in Advances in Plastic and Reconstructive Surgery" Year Book Publishers 95-, 1984

4 Neale HW, "Tissue expanders in the lower face and anterior neck in pediatric burn patients: limitations and pitfalls" 91 (91): 624-, 1993

5 Argenta LC, "The use of tissue expansion in head and neck reconstruction" 11 : 31-, 1983

6 Neumann CG, "The expansion of an area of skin by progressive distention of a subcutaneous balloon; use of the method for securing skin for subtotal reconstruction of the ear" 19 : 124-, 1957

7 Vander Kolk CA, "Some further characteristics of expanded tissue" 14 : 447-, 1987

8 Manders EK, "Soft-tissue expansion in the lower extremities" 81 : 208-, 1988

9 Friedman RM, "Risk factors for complication in pediatric tissue expansion" 98 (98): 1242-, 1996

10 Vergnes P, "Repeated skin expansion for excision of congenital giant nevi in infancy and childhood" 91 (91): 450-, 1993

11 Pasyk KA, "Histopathology of human expanded tissue" 14 : 435-, 1987

12 Austad ED, "Histomorphologic evaluation of guinea pig skin and soft tissue after controlled tissue expansion" 70 : 704-, 1982

13 Bauer BS, "Expanded full-thickness skin grafts in children: case selection, planning, and management" 92 : 59-, 1993

14 Han HS, "Clinical analysis of use of tissue expanders" 18 : 130-, 1991

15 Bauer BS, "Applications of soft tissue expansion in children" 3 : 281-, 1986