Pediatric cervicofacial tissue expansion.
BACKGROUND
Tissue expanders have long been used for reconstructing large cutaneous and fascio-cutaneous defects in children. Previous studies have examined tissue expansion for all body regions, touching upon the head and neck regions. We present a focused review of our experience with cervicofacial tissue expansion in the pediatric population.


METHODS
We retrospectively reviewed 89 children who underwent tissue expansion of the head and neck regions at Children's Hospital of Los Angeles. Most patients underwent multiple expander placements bringing the total expander number to 182. Indications for expansion included congenital nevus [N=39], burn scar [N=14], hemangioma/lymphangioma/arteriovenous malformation [N=11], scar due to trauma [N=10], congenital anomaly [N=5], sebaceous nevus [N=3], cutis aplasia [N=2], tumor [N=2], infection [N=2] and scleroderma [N=1].


RESULTS
Of the 182 expanders placed, 56 had an associated complication (30.8%). The most frequent complications included exposure, infection, leakage, migration, flap necrosis, wound separation, and skull bone remodeling. Expanders placed in the neck appeared to have the highest complication rate.


CONCLUSIONS
This retrospective review identified a high complication rate in pediatric cervicofacial tissue expansion, which is similar to previously published studies. Despite these findings, tissue expansion in pediatric patients should continue to remain a viable reconstructive option, however, proper patient selection; patient education and informed consent involving a discussion of the expected treatment course and risk profile should be undertaken.
Hurvitz
Keith A
KA
University of California Irvine, Aesthetic and Plastic Surgery Institute, Irvine, CA, USA.
Rosen
Heather
H
Meara
John G
JG
D002056:Burns / Q000601:surgery; D002675:Child, Preschool; D002921:Cicatrix / Q000601:surgery; D000013:Congenital Abnormalities / Q000601:surgery; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery; D006391:Hemangioma / Q000601:surgery; D006801:Humans; D007239:Infections / Q000601:surgery; D008202:Lymphangioma / Q000601:surgery; D008297:Male; D009506:Nevus / Q000601:surgery; D012189:Retrospective Studies; D045745:Scleroderma, Limited / Q000601:surgery; D012626:Sebaceous Gland Neoplasms / Q000601:surgery; D015626:Tissue Expansion / Q000009:adverse effects* / Q000379:methods; D015625:Tissue Expansion Devices / Q000706:statistics & numerical data; D016896:Treatment Outcome