Tissue expander Flashcards
epidermal layer becomes thinner with tissue expansion
F epidermal layer thickens in reaction to tissue expansion, whereas the dermal layer becomes thinner
Growth
factors such as platelet-derived growth factor and angiotensin II have
been implicated in cell growth in tissue expander
T
Mechanical creep relies on the skin’s
ability to acutely stretch and increase in surface area during immediate intraoperative tissue expansion
T
collagen fiber realignment occurs in biological creep
F mechanical creep
increased fibroblast and collagen synthesis, increased
myofilaments, increased mitotic activity, and neovascularization occures in biological creep
t
Mechanical creep is very much dependent on the chronicity of controlled tissue
expansion
F Biological creep
the force
required to maintain tissue elongation decreases with time as the tissue expansion is maintained
T
increased number
and caliber of vessels when compared with a nonexpanded counterpart
T
expanded tissues are a form of a delayed flap
T
In tissue expander Decreased hair follicle density occurs
T
With tissue expander the muscle decrease in it thickness
T
Decrease in size and number of mitochondria
F Increased size and number ofmitochondria
capsular formation quality may be better with texture versus smooth tissue
expanders
T
integrated port is less ideal if there is lack
of coverage secondary to the thinning of overlying soft tissue
T
Smoking, radiation, and infections have a higher risk of
wound complications both during the expansion process and afterward
T
direction of movement will be perpendicular to the incision placed to maximize flap coverage and minimize tension during
expansion
T
If the patient is in any discomfort,
the expansion could be stopped and/or fluid can be taken out until
comfortable again
T
Once the goal is met, the second-staged reconstruction can immediately established
F Once the goal is met, it is best to wait 3 to 4 weeks
before the second-staged reconstruction
One can use this
techniqueto cover large defects involving up to 50% of the scalp without significant thinning of the hair-bearing areas.
T
The expander is typically placed in the
subcutanouse plane under the hair-bearing area.
F The expander is typically placed in the
subgaleal plane under hair-bearing area.
Capsulectomies are avoided, as they may devascularize the flap.
Galeotomies may also devascularize the flap, but if carefully done, one
may preserve the galeal blood supply
T
Permanent cranial molding can occurs with expander
F temporary cranial molding occurs with
correction in 3 to 4 months.
Expansion with direct advancement of
tissues can be used to reconstruct 25% to 70% of forehead defects
T
In neck placement of the
expander above the platysma or submuscular aponeurotic system
T
Transgender females to delay breast augmentation until at least
2 years of estrogen therapy
T
tissue expansion of the trunk is associated with
low rates of morbidity and mortality
T
most complications from tissue expansion are minor
T
Complications of tissue expander
Seroma formation, widened scar, discomfort from the
expansion itself, bone resorption, neuropraxia, remenant excessive
soft tissue, and other aesthetic concerns
Major complications
Major complications consist of hematoma, infection, implant
exposure, implant failure or iatrogenic injury, and overlying tissue
compromise
Rectangular expander give 38%
t
The foundation for tissue expansion technique actually has its derivation from distraction osteogenesis
t
epidermal growth factor (EGF) and transforming growth factor (TGF) that
are involved in cell migration, differentiation, and wound healing
T
mechanical creep physiology
displacement of fluids out of the collagen network leading to dehydration of
tissues, collagen fiber realignment in a parallel fashion, elastic fibers
microfragmentation, and adjacent tissue migration into the expanded
field as a result of the stretching force
increased number
and caliber of vessels when compared with a nonexpanded counterpart.17 This can be attributed to increased angiogenic factors such as
vascular endothelial growth factor (VEGF) expressed in expanded
tissues
T
Permanent decrease in fat cells and thickness
T
after mastectomy, tissue expanders are placed in a subpectoral or more recently prepectoral position in conjunction with
acellular dermal matrix for supplemental or total coverage
T
TGF has
been reported to eventually manipulate morphology, migration, and wound healing by enhancing fibroblast growth and
stimulation of extracellular matrix production
T
Collage density remains the same and
increased angiogenesis occurs in tissue expander
T
