Use of tissue expanders with external ports.

The high number of reconstructive dilemmas brought about by more aggressive treatment of congenital malformations and burns has created the need for large quantities of donor skin for local coverage. Tissue expansion with external ports has become part of the authors' surgical armamentarium. From January 1996 to November 1998 the authors placed 34 expanders in 28 patients to correct congenital malformations or burn sequelae. The average patient age at the time of operation was 6.3 years, the average time of expansion was 49 days, and minimal and maximal expansion volume was 60 and 600 cc respectively. Serial injection was carried out every 2 days until total expansion was achieved, and the expanded area was two to three times as wide as the recipient defect. No major complications occurred. The most serious complications of infection and erosion of tissue overlying the device occurred in 17.6% of patients. There are several advantages to this technique: less tissue dissection, painless injections, shorter operating time, and early detection of leaks.