title: Complications of nonbreast tissue expansion: 9 Years experience with 44 adult patients and 119 pediatric patients.
abstract: BACKGROUND
  Tissue expansion is a common reconstructive technique that has been associated with significant complications since its inception. However, the existing literature mostly focuses on complications associated with pediatric tissue expansion only or describes a combined population of adult and pediatric patients, including breast tissue expansion; despite the fact that each of these groups of patients has different characteristics that may affect tissue expansion.
  
  
  OBJECTIVE
  In this study we present a critical review of our experience with complications of nonbreast tissue expansion in adult and pediatric patients and compare between these groups.
  
  
  METHODS
  The charts of patients who underwent nonbreast tissue expansion at Hadassah Medical Center between January 2003 and July 2012 were reviewed. Data were collected including the age of the patient, anatomical site of the expansion, indication and complications.
  
  
  RESULTS
  A total of 202 expansion procedures were performed on 119 pediatric patients (<16 years) and 56 expansion procedures on 44 adult patients. The overall complication rate was 18.2%, with 40 pediatric procedures having complications (19.8%) and 7 adult procedures (12.5%). The difference in complication rates between the two groups was not found to be statistically significant. There was no statistically significant difference in complication rate between the different anatomical areas of expansion in both adult and pediatric patients or between the indications for operation. Most (68%) of the cases with complications underwent subsequent successful reconstruction.
  
  
  CONCLUSIONS
  Despite the consistent high complication rate, tissue expansion can be used as a good reconstructive method in both adult and pediatric patients in all anatomic areas and for different indications.
authors.affiliation: Department of Plastic Surgery, Hadassah Medical Center, Hebrew University School of Medicine, POB 12000, Jerusalem il-91120, Israel. Electronic address: netaad@gmail.com.
authors.forename: Neta
authors.initials: N
authors.lastname: Adler
authors.affiliation: Department of Plastic Surgery, Hadassah Medical Center, Hebrew University School of Medicine, POB 12000, Jerusalem il-91120, Israel.
authors.forename: Jhonatan
authors.initials: J
authors.lastname: Elia
authors.affiliation: Department of Plastic Surgery, Hadassah Medical Center, Hebrew University School of Medicine, POB 12000, Jerusalem il-91120, Israel.
authors.forename: Allan
authors.initials: A
authors.lastname: Billig
authors.affiliation: Department of Plastic Surgery, Hadassah Medical Center, Hebrew University School of Medicine, POB 12000, Jerusalem il-91120, Israel.
authors.forename: Alexander
authors.initials: A
authors.lastname: Margulis
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D015626:Tissue Expansion / Q000379:methods*; D055815:Young Adult
keywords: Burns; Congenital nevi; Pediatric tissue expansion; Scars