Expander reconstruction of tissues in children with pigment and vascular lesions
DOI:
https://doi.org/10.15574/PS.2024.3(84).3137Keywords:
congenital nevi, tissue expander, vascular malformations, tissues reconstructionAbstract
The main indications for surgical treatment of congenital nevi and vascular malformations of superficial tissues are the reduction of psychosocial problems (58%) and the achievement of aesthetic improvement (51%). In the case of large lesions, the problem is the replacement of large tissue defects, which can be solved using tissue expanders.
Aim - establishing the effectiveness and safety of expander reconstruction of surface tissues after removal of large and giant pigment and vascular lesions.
Materials and methods. We performed a retrospective study of 8 patients undergoing superficial tissues expander reconstruction in National children hospital OKHMATDYT in the period 2019-2023. Preoperative planning was carried out in order to determine the shape, size and volume of the expander.
The aim of the first operative intervention was the placement of the expander. During the second planned operation, the expander was removed, the walls of the formed capsule were damaged, a pigment or vascular lesions was completely or partially removed, and the formed flap was moved to the site of the tissue defect.
Results. 19 expanders were used in 8 children for the following indications: congenital nevi (n=6) and vascular malformations (n=2). The age of patients at the time of treatment was from 3 to 17 years. From 1 to 6 expanders were placed in patients. Round (n=1), rectangular (n=10), and sickle-shaped (n=8) expanders were used, the volume of expanders was from 100 to 500 ml. The duration of tissue expansion ranged from 34 to 63 days, on average 43±19. Complete removal of lesions was achieved in 6 (75%) patients, partial removal in 2 (10.5%). Complications that led to the removal of the expander occurred in 2 (10.5%) cases, in particular, hematoma and infection in the area of the scalp and in 1 (5%) case on the background of Herpes zoster infection.
Conclusions. Tissue expansions in order to replace large defects after the removal of pigmented and vascular lesions is safe, effective and aesthetic, as it ensures the replacement of the defect with homogeneous tissues. The overall complication rate was 10.5%. Limitation of tissue expansion use is the young age of the child, skin damage and insufficient area of healthy tissue.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies.
No conflict of interest was declared by the authors.
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