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A Retrospective Analysis on the Proper Size of Tissue Expanders to Treat Scalp Lesions

Aya, Rino MD*; Kawai, Katsuya MD, PhD*; Kawazoe, Takeshi MD, PhD; Suzuki, Shigehiko MD, PhD*

Plastic and Reconstructive Surgery – Global Open: March 2014 - Volume 2 - Issue 3 - p e118
doi: 10.1097/GOX.0000000000000070
Original Articles

Background: Tissue expanders have become established instruments for scalp reconstruction. However, selection of the size of the expander has not been investigated systematically, and it generally depends on the experience of the surgeon.

Methods: We retrospectively analyzed 21 patients who had undergone treatment for scalp lesions using tissue expanders without any complications and measured 2 variables: the volume of the expanders per area of the excised lesions and the hypothetical stretched functional skin width relative to the width of the excised lesions. We also sought to evaluate the relationship between these 2 variables and the need for revision surgery during the postoperative course.

Results: The need for revision surgery was statistically higher in patients with a volume of 7 ml/cm2 lesion or less and width of functional skin of less than 2.5 cm/cm lesion (P < 0.05). For scar repairs, the required size and volume of the expanders tended to be larger than those required for any other lesions.

Conclusions: Expanders that generate functional skin at least more than 2.5 times the width of the lesion and have a volume more than 7 ml/cm2 lesion are necessary to cover scalp lesions without complications.

From the *Department of Plastic and Reconstructive Surgery, Graduate school of Medicine, Kyoto University, Kyoto, Japan; and Department of Plastic Surgery, Yoshikawa Hospital, Kyoto, Japan.

Received for publication September 9, 2013; accepted January 31, 2014.

Disclosure: The authors have no financial interest to declare in relation to the content of this article. The Article Processing Charge was paid for by the authors.

Rino Aya, MD Department of Plastic and Reconstructive Surgery Graduate school of Medicine Kyoto University 54 Shogoin Kawaharacho Sakyou-ku Kyoto 606–8507 Japan E-mail:

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© 2014 American Society of Plastic Surgeons