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Osmotic expanders in children: no filling - no control - no problem?


Böttcher-Haberzeth, S; Kapoor, S; Meuli, M; Neuhaus, K; Biedermann, T; Reichmann, E; Schiestl, C (2011). Osmotic expanders in children: no filling - no control - no problem? European Journal of Pediatric Surgery, 21(3):163-167.

Abstract

BACKGROUND:

Self-filling, hydrogel-based osmotic tissue expanders have been successfully used for several years, mainly in adult patients. We wanted to test this novel device in pediatric plastic and reconstructive surgery.
MATERIAL AND METHODS:

Between November 2004 and September 2009, we implanted 53 osmotic tissue expanders following standard surgical principles in a total of 30 children and adolescents with burn scars, congenital nevi, alopecia, or foot deformities.
RESULTS:

All expanders reached their predicted volume within 6 weeks and 51 (96.2%) produced a sufficient amount of additional skin for the intended coverage of the defect. A serious infection precluding the planned reconstructive procedure occurred with 2 expanders (3.8%). Minor complications occurred at 6 implantation sites (11.4%), and consisted of small necrotic areas and perforations (n = 3) and minor infections (n = 3). These problems could be controlled and did not interfere with the subsequent plasty. The final results recorded at the last follow-up (mean: 21 months, range: 9-48 months) were rated as excellent in 25, good in 19, moderate in 6, and poor in 1 patient.
CONCLUSION:

This is apparently the largest pediatric series in which self-filling expanders have been used. The data obtained indicates that self-filling expanders can be safely and effectively used for various plastic, reconstructive and orthopedic procedures in children and adolescents. The fact that numerous painful and distressing filling sessions are obviated with these expanders is particularly beneficial for those children too young to understand and cooperate. Moreover, this approach minimizes the risk of infection and lowers costs.

© Georg Thieme Verlag KG Stuttgart · New York.

BACKGROUND:

Self-filling, hydrogel-based osmotic tissue expanders have been successfully used for several years, mainly in adult patients. We wanted to test this novel device in pediatric plastic and reconstructive surgery.
MATERIAL AND METHODS:

Between November 2004 and September 2009, we implanted 53 osmotic tissue expanders following standard surgical principles in a total of 30 children and adolescents with burn scars, congenital nevi, alopecia, or foot deformities.
RESULTS:

All expanders reached their predicted volume within 6 weeks and 51 (96.2%) produced a sufficient amount of additional skin for the intended coverage of the defect. A serious infection precluding the planned reconstructive procedure occurred with 2 expanders (3.8%). Minor complications occurred at 6 implantation sites (11.4%), and consisted of small necrotic areas and perforations (n = 3) and minor infections (n = 3). These problems could be controlled and did not interfere with the subsequent plasty. The final results recorded at the last follow-up (mean: 21 months, range: 9-48 months) were rated as excellent in 25, good in 19, moderate in 6, and poor in 1 patient.
CONCLUSION:

This is apparently the largest pediatric series in which self-filling expanders have been used. The data obtained indicates that self-filling expanders can be safely and effectively used for various plastic, reconstructive and orthopedic procedures in children and adolescents. The fact that numerous painful and distressing filling sessions are obviated with these expanders is particularly beneficial for those children too young to understand and cooperate. Moreover, this approach minimizes the risk of infection and lowers costs.

© Georg Thieme Verlag KG Stuttgart · New York.

Citations

2 citations in Web of Science®
4 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Clinic for Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2011
Deposited On:10 Feb 2012 19:50
Last Modified:05 Apr 2016 15:33
Publisher:Georg Thieme Verlag
ISSN:0939-7248 (P) 1439-359X (E)
Publisher DOI:10.1055/s-0030-1270460
PubMed ID:21283960

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