title: Complications of tissue expansion in a public hospital.
abstract: Avoidance of complications in tissue expansion requires careful outpatient observation and consistent follow-up-two factors that are difficult to manage in a city hospital-based population. To determine the complication rate of tissue expanders in a given population, the authors reviewed retrospectively 34 tissue expanders placed in 30 patients at a New York City public hospital over a 7-year period from 1989 to 1996. The mean age of the patients at the time of insertion was 25 years (range, 11 months-65 years). The most common conditions for treatment were nevi (N = 11), burn scars (N = 8), breast reconstructions (N = 8), and spina bifida (N = 4). Complications occurred in 22 of 34 expanders (65%). Complications included deep infection (N = 11), exposure (N = 7), breakdown of the surgical wound (N = 4), cellulitis (N = 3), drainage (N = 1), and deflation (N = 1). Major complications resulted in premature removal in 13 of 34 expanders (38%). Minor complications leading to successful completion of the expansion process occurred with 9 of 34 expanders (27%). No complications were recorded in the remaining 12 of 34 expanders (35%). Although tissue expansion is a potentially safe and effective method of reconstruction, this review should alert the surgeon to the distinct challenges that may be encountered in the public hospital.
authors.affiliation: Institute of Reconstructive Plastic Surgery, New York University Medical Center, NY 10016, USA.
authors.forename: T
authors.initials: T
authors.lastname: Youm
authors.forename: M
authors.initials: M
authors.lastname: Margiotta
authors.forename: A
authors.initials: A
authors.lastname: Kasabian
authors.forename: N
authors.initials: N
authors.lastname: Karp
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002056:Burns / Q000150:complications / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D007223:Infant; D007239:Infections / Q000209:etiology; D016462:Mammaplasty; D008875:Middle Aged; D009506:Nevus / Q000151:congenital / Q000601:surgery; D011183:Postoperative Complications; D012878:Skin Neoplasms / Q000151:congenital / Q000601:surgery; D016137:Spina Bifida Cystica / Q000601:surgery; D015626:Tissue Expansion