TY - JOUR
T1 - External port tissue expansion in the pediatric population
T2 - Confirming its safety and efficacy
AU - Azadgoli, Beina
AU - Fahradyan, Artur
AU - Wolfswinkel, Erik M.
AU - Tsuha, Michaela
AU - Magee, William
AU - Hammoudeh, Jeffrey A.
AU - Urata, Mark M.
AU - Howell, Lori K.
N1 - Publisher Copyright:
Copyright © 2018 by the American Society of Plastic Surgeons.
PY - 2018/6
Y1 - 2018/6
N2 - Background: External filling ports in tissue expander–based reconstruction have the advantages of being associated with less pain and emotional distress. However, among practicing surgeons using tissue expansion, a theoretical concern remains regarding higher risk of infection. The authors’ goal was to evaluate external port safety in the pediatric population by looking at the complications and overall success rate of reconstruction. Methods: A retrospective review of all patients undergoing tissue expansion using external ports at Children’s Hospital Los Angeles between January of 2008 and June of 2016 was conducted. Patient demographic and perioperative data were collected and analyzed. Results: Two hundred forty-one expanders were placed in 100 pediatric patients, resulting in 123 procedures for congenital and acquired conditions, with an average age at the time of surgery of 7.1 years (range, 1 month to 19.9 years) and average follow-up length of 2.5 years (range, 2.8 months to 8.8 years). The overall complication rate was 29.9 percent, and the infection rate was 17 percent. The majority of these cases were treated conservatively without additional need for surgery. Of 123 cases, 25 required premature expander removal because of complications. Despite early intervention, 21 of these cases underwent successful completion of their reconstruction according to the preoperative plan, resulting in an overall 96.7 percent success rate of tissue expander reconstruction. Conclusions: In children, who are often less tolerant of the pain and distress associated with internal port expansion, the authors encourage the use of external ports. This study found a high success rate in terms of successful reconstruction, with the majority of complications being treated conservatively.
AB - Background: External filling ports in tissue expander–based reconstruction have the advantages of being associated with less pain and emotional distress. However, among practicing surgeons using tissue expansion, a theoretical concern remains regarding higher risk of infection. The authors’ goal was to evaluate external port safety in the pediatric population by looking at the complications and overall success rate of reconstruction. Methods: A retrospective review of all patients undergoing tissue expansion using external ports at Children’s Hospital Los Angeles between January of 2008 and June of 2016 was conducted. Patient demographic and perioperative data were collected and analyzed. Results: Two hundred forty-one expanders were placed in 100 pediatric patients, resulting in 123 procedures for congenital and acquired conditions, with an average age at the time of surgery of 7.1 years (range, 1 month to 19.9 years) and average follow-up length of 2.5 years (range, 2.8 months to 8.8 years). The overall complication rate was 29.9 percent, and the infection rate was 17 percent. The majority of these cases were treated conservatively without additional need for surgery. Of 123 cases, 25 required premature expander removal because of complications. Despite early intervention, 21 of these cases underwent successful completion of their reconstruction according to the preoperative plan, resulting in an overall 96.7 percent success rate of tissue expander reconstruction. Conclusions: In children, who are often less tolerant of the pain and distress associated with internal port expansion, the authors encourage the use of external ports. This study found a high success rate in terms of successful reconstruction, with the majority of complications being treated conservatively.
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U2 - 10.1097/PRS.0000000000004372
DO - 10.1097/PRS.0000000000004372
M3 - Article
C2 - 29794706
AN - SCOPUS:85055670533
SN - 0032-1052
VL - 141
SP - 883e-890e
JO - Plastic and reconstructive surgery
JF - Plastic and reconstructive surgery
IS - 6
ER -