title: [Tissue expansion in children: Indications and management of complications. A 10-year experience].
abstract: BACKGROUND
  Tissue expansion is a plastic surgery technique which enables optimal quality and skin surface reconstruction in case of soft tissue defect. Despite the good results obtained, both from a functional and aesthetic point of view, there is a high rate of complications whose management seems to be essential to ensure satisfactory results.
  
  
  METHODS
  We retrospectively reviewed the medical files of 45 children treated in our department between 2002 and 2012: 73 expanders were placed during 51 protocols.
  
  
  RESULTS
  The studied protocols gathered a large variety of situations. Varied pathologies were treated: burn sequelae (39 %), giant congenital naevus (GCN) (27 %), scars (20 %), hamartoms (8 %), cutis aplasia (6 %), as well as diverse sites: scalp (45 %), trunk (35 %), head and neck (8 %), lower extremity (8 %), upper extremity (4 %). Complications occurred in 17 protocols representing 26 % of total expanders. GCN is a pathology with a significantly lower complication rate (P=0.013) whereas trunk is an anatomical location with a significantly higher complication rate (P=0.026). Overall, 84 % of reconstructions were evaluated as having a good result. This rate reached 76 % for complicated protocols.
  
  
  CONCLUSIONS
  Tissue expansion in paediatric patients remains an efficient therapy in order to achieve a satisfactory reconstruction. Despite a high complication rate, good results can be obtained even in those complicated cases as long as they are well managed and anticipated. We also think that specific paediatric material would help to reduce supervention of some complications.
authors.affiliation: Service de chirurgie plastique, reconstructrice et esthétique, hôpital Trousseau, CHRU de Tours, 37044 Tours cedex 9, France. Electronic address: marine.bompaire@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Duclert-Bompaire
authors.affiliation: Service de chirurgie plastique, reconstructrice et esthétique, hôpital Trousseau, CHRU de Tours, 37044 Tours cedex 9, France.
authors.forename: A
authors.initials: A
authors.lastname: Sallot
authors.affiliation: Service de chirurgie viscérale et plastique pédiatrique, hôpital Clocheville, CHRU de Tours, 37044 Tours cedex 9, France.
authors.forename: H
authors.initials: H
authors.lastname: Lardy
authors.affiliation: Service de chirurgie viscérale et plastique pédiatrique, hôpital Clocheville, CHRU de Tours, 37044 Tours cedex 9, France.
authors.forename: A
authors.initials: A
authors.lastname: Le Touze
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000209:etiology* / Q000628:therapy*; D012189:Retrospective Studies; D012867:Skin / Q000293:injuries*; D012868:Skin Abnormalities / Q000601:surgery*; D012871:Skin Diseases / Q000601:surgery*; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps / Q000601:surgery; D015626:Tissue Expansion / Q000379:methods*
keywords: Child; Complications; Enfant; Expandeur; Expansion cutanée; Results; Résultats; Tissue expansion