title: A retrospective analysis on the proper size of tissue expanders to treat scalp lesions.
abstract: BACKGROUND
  Tissue expanders have become established instruments for scalp reconstruction. However, selection of the size of the expander has not been investigated systematically, and it generally depends on the experience of the surgeon.
  
  
  METHODS
  We retrospectively analyzed 21 patients who had undergone treatment for scalp lesions using tissue expanders without any complications and measured 2 variables: the volume of the expanders per area of the excised lesions and the hypothetical stretched functional skin width relative to the width of the excised lesions. We also sought to evaluate the relationship between these 2 variables and the need for revision surgery during the postoperative course.
  
  
  RESULTS
  The need for revision surgery was statistically higher in patients with a volume of 7 ml/cm(2) lesion or less and width of functional skin of less than 2.5 cm/cm lesion (P < 0.05). For scar repairs, the required size and volume of the expanders tended to be larger than those required for any other lesions.
  
  
  CONCLUSIONS
  Expanders that generate functional skin at least more than 2.5 times the width of the lesion and have a volume more than 7 ml/cm(2) lesion are necessary to cover scalp lesions without complications.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate school of Medicine, Kyoto University, Kyoto, Japan; and Department of Plastic Surgery, Yoshikawa Hospital, Kyoto, Japan.
authors.forename: Rino
authors.initials: R
authors.lastname: Aya
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate school of Medicine, Kyoto University, Kyoto, Japan; and Department of Plastic Surgery, Yoshikawa Hospital, Kyoto, Japan.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Kawai
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate school of Medicine, Kyoto University, Kyoto, Japan; and Department of Plastic Surgery, Yoshikawa Hospital, Kyoto, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kawazoe
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate school of Medicine, Kyoto University, Kyoto, Japan; and Department of Plastic Surgery, Yoshikawa Hospital, Kyoto, Japan.
authors.forename: Shigehiko
authors.initials: S
authors.lastname: Suzuki