Tissue expansion for correction of scars due to burn and other causes: A retrospective comparative study of various complications

• Published in: Burns 2013-08, Vol.39 (5), p.984-989
• Main Authors: Fochtmann, A, Keck, M, Mittlböck, M, Rath, Th
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Burn; Burns - complications; Child; Child, Preschool; Cicatrix, Hypertrophic - etiology; Cicatrix, Hypertrophic - surgery; Critical Care; Female; Humans; Infant; Male; Middle Aged; Multivariate Analysis; Pediatric burn patient; Postoperative Complications; Retrospective Studies; Risk Factors; Scar correction; Sex Distribution; Skin Neoplasms - surgery; Tissue expander; Tissue Expansion - methods; Young Adult
• ISSN: 0305-4179; 1879-1409
• DOI: 10.1016/j.burns.2012.10.020

Abstract Background Tissue expansion is associated with a relatively high complication rate. The aim of this study was to quantify the complication risk of burn scar patients who underwent tissue expansion in comparison to patients with other indications such as skin tumors. Furthermore it was attempted to compare the complication rates in children and adults. Methods A retrospective analysis was performed on 148 expanders implanted in 73 patients during the years 1994–2011. Two patient cohorts ( burn scar cohort n = 31 and other indication cohort n = 42) were identified and analyzed. Results 27 male and 46 female patients with a median age of 21 years were included. No statistically significant difference for complication risk between the burn and other indication cohorts could be found ( p = 0.1412). Statistical analyses revealed a higher complication rate (52%) in the lower limb compared to all other anatomic sites (29%) ( p = 0.1746). In addition, statistical analyses revealed a significantly higher total complication rate in children younger than 10 years ( p = 0.0043). Moreover a greater TBSA was accompanied by a higher complication rate ( p = 0.0258). Conclusion This set of data suggests that the burn scar patient is at no greater risk to suffer complications from tissue expansion. Other factors like age, TBSA and anatomical site have far more influence on the expander complication rate than the initial indication for tissue expansion.