title: External tissue expander for closing large defects of the extremities and trunk.
abstract: BACKGROUND
  Direct closure is the reconstruction of choice for surface soft tissue defects; however, it may not be suitable for larger defects due to extensive tension. A variety of techniques are available for achieving tension free closure, including skin grafts, skin flaps, and internal or external tissue expansion.
  
  
  METHODS
  The external skin expander developed by Blomqvist and Steenfos consists of single tissue expander units that contain an atraumatic needle and two friction stoppers connected via a silicone string. Each device of the expander is inserted under local anaesthesia on each side of the defect at a distance of about 2 cm from each other. Postoperative the silicone strings have to be tightened at least once a day. After about 5 to 10 days a sufficient expansion is achieved and the defect can be closed directly after expander removal.
  
  
  RESULTS
  The external tissue expander developed by Blomqvist and Steenfos is an efficient, time-effective, easy-to-handle device that can be inserted under local anesthesia, providing a good functional and satisfactory cosmetic outcome. Due to the comparatively low complication rate, even outpatient treatment is possible. The major drawback of this technique is the possibility of developing uncommon secondary scars under the plastic stoppers.
authors.forename: Julia
authors.initials: J
authors.lastname: Kirschke
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Georgas
authors.forename: Michael
authors.initials: M
authors.lastname: Sand
authors.forename: Falk G
authors.initials: FG
authors.lastname: Bechara
mesh_terms: D004867:Equipment Design; D005121:Extremities / Q000601:surgery*; D006801:Humans; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps; D015626:Tissue Expansion / Q000295:instrumentation*; D015625:Tissue Expansion Devices; D060726:Torso / Q000601:surgery*