Tissue Expansion in Reconstructive Surgery: A 10-Year Experience in Kosovo

Abstract

Background: Tissue expansion (TE) is one of the major developments in reconstructive surgery. The objective of this research was a retrospective analysis of our 10-year experience in correcting burn sequelae, traumas, and scars by the method of TE. Methods and Results: A retrospective study was conducted at the Clinic of Plastic and Reconstructive Surgery at the University Clinical Center of Kosovo (UCCK, Prishtina) from January 2009 to December 2019. The sample included 67 patients (43[64.2%] females and 24[35.8%] males) treated with tissue expanders for reconstructive purposes. The most common indication for TE was burn sequelae, trauma, and scars from previous surgery. One hundred and thirty-five expanders were placed on 67 patients, and 128 operative interventions were performed. Burn sequelae (55.2%) were the main reason for TE. The age of patients was in the range of 0-50 years (mean age of 20.5 years). The predominant age groups were 11-20 years (49.2%) and 21-30 (40.3%). The most common anatomical region for TE was the head, including the face and neck (47.8%), followed by the trunk (22.4%), the lower extremities (16.4%), and the upper extremities (13.4%). Most patients underwent only one (61.2%) or two surgical interventions (31.3%); three surgical interventions were performed in 7.5% of cases. One expander was placed in the vast majority of our patients (83.6%), two expanders in 13.4% of cases, and three expanders in 3.0% Patients with expanders on the head and neck experienced more major complications (12.5%), which ended with the removal of the expander, than those with expanders on the trunk (6.7%) and lower extremities (9.1%). Minor complications most often (18.2%) occurred on the lower extremities. These complications were evidenced by pain and transient ischemia, which did not preclude the attainment of reconstructive goals. Patients of 0 to 10 years of age had only minor complications. Occurrences of major complications were the most frequent in the age groups of 11-20(9.1%), 21-30(11.1%), and 31-40(33.3%) years. Conclusion: The results of our retrospective study on the efficacy of cutaneous expansion procedures are broadly in line with other research reported in the literature. Attention to different aspects of TE, including careful patient selection and meticulous attention to intervention detail, are the main conditions for the success of this reconstructive surgery.