title: Intraoperative tissue expansion in eyelid reconstruction.
abstract: OBJECTIVE
  Chronic tissue expansion is a well-accepted modality for increasing available tissue for reconstructive surgery. In rapid intraoperative tissue expansion (RITE), a tissue expander is used intraoperatively to increase the available tissue area for defect closure. The use of the ubiquitous and inexpensive Foley catheter has previously been reported as a tissue expander in RITE. In this paper, the authors examine the application of the Foley catheter for RITE in oculoplastic surgery.
  
  
  METHODS
  Case series.
  
  
  METHODS
  Twenty-six patients (ages 50 to 87) with eyelid defects from various causes underwent reconstruction using RITE.
  
  
  METHODS
  Using this technique, the tip of a #14 French Foley catheter is trimmed, keeping the balloon intact. The balloon is inserted under a skin-muscle flap. Counter traction is applied, and the balloon is filled with saline until the flap blanches. The balloon is inflated twice for 5 minutes with a 1- to 2-minute rest period between expansions. This provides increased tissue area for reconstruction of periocular defects.
  
  
  METHODS
  The linear extent of the eyelid defect was measured prior to and after expansion with RITE. A comparison was made between the two measurements.
  
  
  RESULTS
  The linear extent of the eyelid margin defect decreased by 36% after RITE.
  
  
  CONCLUSIONS
  Rapid intraoperative tissue expansion with a Foley catheter is a means of providing increased tissue area for reconstructive surgery of the eyelids and periorbital region. This technique provides excellent tissue match for color, texture, and thickness. The technique decreases the size of the incised and undermined skin-muscle flap and the tension needed for wound closure.
authors.affiliation: Oculoplastics/Orbital Service, Cleveland Clinic Foundation, OH 44195, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Foster
authors.forename: A J
authors.initials: AJ
authors.lastname: Scheiner
authors.forename: A E
authors.initials: AE
authors.lastname: Wulc
authors.forename: I B
authors.initials: IB
authors.lastname: Wallace
authors.forename: S S
authors.initials: SS
authors.lastname: Greenbaum
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002404:Catheterization / Q000295:instrumentation*; D005143:Eyelids / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013518:Surgery, Plastic / Q000379:methods; D013524:Surgical Flaps; D015626:Tissue Expansion / Q000295:instrumentation / Q000379:methods*; D015625:Tissue Expansion Devices