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Serial Tissue Expansion at the Same Site in Pediatric Patients: Is the Subsequent Expansion Faster?

  • Lee, Moon Ki (Department of Plastic and Reconstructive Surgery, Institute of Human-Environment Interface Biology, Seoul National University College of Medicine) ;
  • Park, Seong Oh (Department of Plastic and Reconstructive Surgery, Institute of Human-Environment Interface Biology, Seoul National University College of Medicine) ;
  • Choi, Tae Hyun (Department of Plastic and Reconstructive Surgery, Institute of Human-Environment Interface Biology, Seoul National University College of Medicine)
  • Received : 2017.05.24
  • Accepted : 2017.10.18
  • Published : 2017.11.18

Abstract

Background Serial tissue expansion is performed to remove giant congenital melanocytic nevi. However, there have been no studies comparing the expansion rate between the subsequent and preceding expansions. In this study, we analyzed the rate of expansion in accordance with the number of surgeries, expander location, expander size, and sex. Methods A retrospective analysis was performed in pediatric patients who underwent tissue expansion for giant congenital melanocytic nevi. We tested four factors that may influence the expansion rate: The number of surgeries, expander location, expander size, and sex. The rate of expansion was calculated by dividing the 'inflation amount' by the 'expander size'. Results The expansion rate, compared with the first-time group, was 1.25 times higher in the second-or-more group (P=0.04) and 1.84 times higher in the third-or-more group (P<0.01). The expansion rate was higher at the trunk than at other sites (P<0.01). There was a tendency of lower expansion rate for larger expanders (P=0.03). Sex did not affect the expansion rate. Conclusions There was a positive correlation between the number of surgeries and the expansion rate, a positive correlation between the expander location and the expansion rate, and a negative correlation between the expander size and the expansion rate.

Keywords

References

  1. Kang HG, Park MC, Park DH. A new modality for treating congenital melanocytic nevus: "cogwheel pattern" serial excision method. Arch Plast Surg 2014;41:418-20. https://doi.org/10.5999/aps.2014.41.4.418
  2. Rasmussen BS, Henriksen TF, Kolle SF, et al. Giant congenital melanocytic nevus: report from 30 years of experience in a single department. Ann Plast Surg 2015;74:223-9. https://doi.org/10.1097/SAP.0b013e3182920c3d
  3. Ma T, Fan K, Li L, et al. Tissue expansion in the treatment of giant congenital melanocytic nevi of the upper extremity. Medicine (Baltimore) 2017;96:e6358. https://doi.org/10.1097/MD.0000000000006358
  4. Arneja JS, Gosain AK. Giant congenital melanocytic nevi. Plast Reconstr Surg 2007;120:26e-40e. https://doi.org/10.1097/01.prs.0000267583.63342.0a
  5. Tepole AB, Ploch CJ, Wong J, et al. Growing skin: a computational model for skin expansion in reconstructive surgery. J Mech Phys Solids 2011;59:2177-90. https://doi.org/10.1016/j.jmps.2011.05.004
  6. Johnson PE, Kernahan DA, Bauer BS. Dermal and epidermal response to soft-tissue expansion in the pig. Plast Reconstr Surg 1988;81:390-7. https://doi.org/10.1097/00006534-198803000-00013
  7. Jeong C, Chung HY, Lim HJ, et al. Applicability and safety of in vitro skin expansion using a skin bioreactor: a clinical trial. Arch Plast Surg 2014;41:661-7. https://doi.org/10.5999/aps.2014.41.6.661
  8. Johnson TM, Lowe L, Brown MD, et al. Histology and physiology of tissue expansion. J Dermatol Surg Oncol 1993;19:1074-8. https://doi.org/10.1111/j.1524-4725.1993.tb01002.x
  9. Zollner AM, Buganza Tepole A, Gosain AK, et al. Growing skin: tissue expansion in pediatric forehead reconstruction. Biomech Model Mechanobiol 2012;11:855-67. https://doi.org/10.1007/s10237-011-0357-4
  10. Cua AB, Wilhelm KP, Maibach HI. Elastic properties of human skin: relation to age, sex, and anatomical region. Arch Dermatol Res 1990;282:283-8. https://doi.org/10.1007/BF00375720
  11. Nedelec B, Forget NJ, Hurtubise T, et al. Skin characteristics: normative data for elasticity, erythema, melanin, and thickness at 16 different anatomical locations. Skin Res Technol 2016;22:263-75. https://doi.org/10.1111/srt.12256
  12. Hudson DA, Lazarus D, Silfen R. The use of serial tissue expansion in pediatric plastic surgery. Ann Plast Surg 2000;45: 589-93. https://doi.org/10.1097/00000637-200045060-00003

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  3. Multifactorial analysis of the surgical outcomes of giant congenital melanocytic nevi: Single versus serial tissue expansion vol.47, pp.6, 2017, https://doi.org/10.5999/aps.2020.01494