[The complications of skin expansion in paediatrics: Diagnostic, taking over and prevention].
Skin expansion is a difficult and long process in which can occur more or less serious complications. Overall complications rates describe in the literature vary between 13 and 37%. We can categorize them in major complications, which can lead to a failure maybe even an aggravation of the anterior status, and in minor complications that do not compromise the expansion process but can alter it. The main major complications are infection, skin suffering and necrosis which can lead to prosthesis exposition, leaks and technical problems with equipment dysfunctions that may cause difficulties or a failure of the inflations. The main minor complications are hematomas, seromas, valve or tube exposition, pains with paraesthesias caused by neighbouring organs compression, pathologic and unsightly scares and can lead to an important psychological impact. These complications can be due to a precarious skin's state, a material dysfunction or unpredictable technical problems but also by an inappropriate preoperative indication or planning. The emerging of a complication, however, is not synonymous to a failure of the procedure; a satisfactory reconstruction may still be obtained in 75% of all cases. The purpose of this article is to help to identify the situations at risk of complications in order to prevent, detect and treat them early.
Chirurgie plastique reconstructrice et esthétique, hôpital de La Conception, 147, boulevard Baille, 13005 Marseille, France. Electronic address: pascalsebastien@gmail.com.
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Pascal
Chirurgie plastique reconstructrice et esthétique, hôpital Nord, chemin des Bourrely, 13015 Marseille, France. Electronic address: cecile.philandrianos@ap-hm.fr.
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Philandrianos
Chirurgie plastique reconstructrice et esthétique, hôpital de La Conception, 147, boulevard Baille, 13005 Marseille, France. Electronic address: baptiste.bertrand@ap-hm.fr.
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Bertrand
Chirurgie plastique reconstructrice et esthétique, hôpital de La Conception, 147, boulevard Baille, 13005 Marseille, France. Electronic address: jacques.bardot@ap-hm.fr.
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Bardot
Chirurgie plastique pédiatrique, hôpital de la Timone Enfants, 264, rue Saint-Pierre, 13005 Marseille, France. Electronic address: nathalie.degardin@ap-hm.fr.
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Degardin
Chirurgie plastique reconstructrice et esthétique, hôpital de La Conception, 147, boulevard Baille, 13005 Marseille, France. Electronic address: dominique.casanova@ap-hm.fr.
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Casanova
D000465:Algorithms; D002648:Child; D006801:Humans; D009336:Necrosis; D012867:Skin / Q000473:pathology; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D015626:Tissue Expansion / Q000009:adverse effects*
Complication; Expansion cutanée; Facteurs de risques; Paediatric; Prevention; Prévention; Pédiatrie; Risk factor; Skin expansion