The influence of expander injection port placement on complications of retroauricular soft tissue expander implantation and treatment strategy
10.3760/cma.j.cn114453-20230119-00009
- VernacularTitle:扩张器注射壶安置方式对耳后扩张器置入术后并发症发生的影响及处理策略
- Author:
Jun GE
1
;
Yongzhen WANG
;
Qunzhen ZHONG
;
Cheng CHEN
Author Information
1. 中山大学孙逸仙纪念医院整形外科，广州 510288
- Keywords:
Tissue expansion;
Postoperative complications;
Congenital microtia;
Internal expander injection port;
External expander injection port
- From:
Chinese Journal of Plastic Surgery
2023;39(3):245-251
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the influence of expander injection port placement on complications of retroauricular soft tissue expander implantation and put forward the corresponding treatment countermeasures.Methods:Data of the patients with congenital microtia or acquired ear defects who were treated in the Department of Plastic Surgery of Sun Yat-sen Memorial Hospital from January 2016 to August 2022 were retrospectively analyzed. All patients underwent ear reconstruction with skin expansion. According to the placement of the expander injection port in the operation, all patients were divided into the group of internal expander injection port (referred to as the internal group) and the group of external expander injection port (referred to as the external group). After the operation, patients of these two groups underwent skin expansion. The general information of the local region and the occurrence of related complications were observed in both groups. Chi-square test was used for statistical analysis.Results:A total of 51 patients were included in this study, including 42 males and 9 females, with an average age of 13.1 years from 5 years old to 43 years old. There were 19 cases of left side, 31 cases of right side, 1 case of both sides. There were 21 cases in the internal group and 30 cases in the external group. There were 19 patients in total who suffered complications such as hematoma, infection, ischemic necrosis of the flap, expander exposure and expander damage. Complications occurred in 6 cases in the internal group, i. e., hematoma in 3 cases and expander exposure in 3 cases. And complications occurred in 13 patients in the external group, including hematoma in 5 cases, infection in 2 cases, expander damage in 1 case, hematoma combined infection in 2 cases, infection combined expander exposure in 1 case, ischemic necrosis of the flap combined expander exposure in 1 case and hematoma combined ischemic necrosis of the flap and expander exposure in 1 case. Patients with all the above-mentioned complications received the second-stage auricle reconstruction surgery on schedule or ahead of schedule after treatment of the complications, and the postoperative effect was good. The incidence of infection was higher in the external group[28.57%(6/21)vs.43.33%(13/30)], and there were significant differences in the incidence of infection between the two groups ( χ2=3.88, P<0.05), but no significant differences in hematoma ( χ2=1.12, P>0.05), ischemic necrosis of the flap ( χ2=1.46, P>0.05), expander exposure ( χ2=0.22, P>0.05) or expander damage ( χ2=0.71, P>0.05). Conclusion:External expander injection port can increase the incidence of postoperative infection. The expander injection port placement does not significantly influence on the incidence of complications such as hematoma, ischemic necrosis of the flap, expander exposure and expander damage. However, the characteristics of these complications in the two kinds of injection port placement are different, and there are some differences in their treatment countermeasures.
