According to the clinical needs of treatment for the carpal tunnel syndrome, a transparent combined dilation conductor was developed for the endoscopic carpal tunnel release. There are kinds of characters for this conductor: good photo permeability, facility to operation, easy to use, no toxic effect, low system cost etc.
Carpal Tunnel Syndrome ; surgery ; Humans ; Tissue Expansion ; instrumentation ; methods ; Tissue Expansion Devices ; Treatment Outcome

Hairless scalp areas can occur due to trauma, tumors, or congenital disease. This aesthetically unpleasing condition can lead to psychosocial distress, and thin skin flaps may be prone to scarring. Treating the hairless scalp by simple excision is challenging because of skin tension. Tissue expanders are a good option for hairless scalp resurfacing. However, a single expansion may be inadequate to cover the entire defect. This report describes good results obtained using a serial resurfacing method involving re-expansion of the flap with a tissue expander to treat two patients with large lesions: one due to aplasia cutis congenital and another who underwent dermatofibrosarcoma protuberance resection. The results suggest that scalp resurfacing by serial tissue expansion using a tissue expander can be used for extensive lesions.
Alopecia ; Cicatrix ; Dermatofibrosarcoma ; Humans ; Methods ; Scalp ; Skin ; Tissue Expansion ; Tissue Expansion Devices

OBJECTIVETo observe the ultrastrual changes of the skin between the continuous tissue expansion and the conventional tissue expansion.

METHODSTwelve white piglets were used for this study on an animal model of tissue expansion with the continuous tissue expansion group and the conventional tissue expansion group. The tissue samples in each group were harvested and prepared for the transmission electron microscope observation.

RESULTSThe interspace among basal cells and spinose cells was increasing and the numbers of cell conjunctures were decreasing in the both groups. However, these changes in the continuous tissue expansion group were more obvious than in the conventional tissue expansion group. In the dermal layer of the skin, the ultrastructure of collagen fibers were basically normal. But, the fibroblasts and capillary endothelia cells were more activated in the continuous tissue expansion group, compared with the conventional tissue expansion group. The fibroblast apoptosis and collagenolysis spots were observed in both of the groups, while the red blood cells were also found in the tissue leaked outsides from the blood vascular cavities.

CONCLUSIONTissue expansion may result in tissue growth and tissue degeneration in the same time.

Animals ; Microscopy, Electron ; Skin ; cytology ; ultrastructure ; Swine ; Tissue Expansion ; methods

OBJECTIVETo investigate a more simple and effective method to repair cicatrix by tissue expansion.

METHODSThe dilator with the capacity of 80 - 500 ml was implanted into the subcutaneous pocket under the cicatrix. After dilating for one to two months, the dilator was taken out and the wound surface of the cicatrix was removed. The expanded skin flap was advanced or rotated to cover the defects. The procedure was used on 203 cases.

RESULTSThe dilatation was achieved successfully in all the cases, followed by cicatrix removing and repair. The incision scar was not noticeable.

CONCLUSIONSTissue expansion under the cicatrix has the advantages of safety, less trauma and less extra incisions. It is a reasonable choice to obtain more flexible surgical designs and more economical skin flap applications. It is suitable for most of the treatment for cicatrix.

Adolescent ; Adult ; Child ; Child, Preschool ; Cicatrix ; surgery ; Female ; Humans ; Male ; Middle Aged ; Tissue Expansion ; methods ; Tissue Expansion Devices ; Young Adult

OBJECTIVETo develop and evaluate the computer-aided system in measurement of expanded skin and preoperative planning.

METHODSStereophotogrammetric technique was used to gain the 3D image-pairs, from which the contours of the expanded sites were restored. The 3D surface data were provided to the specially developed "computer-aided tissue expansion 3D profilometry and surgery planning system", to calculate the expansion area and help the preoperative design.

RESULTSThe system has been applied clinically in 16 tissue expansion sites of 11 patients with fairly good results since March 1999. Compared with the traditional method, this system is accurate, repeatable and feasible.

CONCLUSIONThis technique is useful and promising for improving the operation of tissue expansion.

Adult ; Dermatologic Surgical Procedures ; Humans ; Imaging, Three-Dimensional ; methods ; Male ; Skin ; injuries ; Surgical Flaps ; Tissue Expansion ; Tissue Expansion Devices

OBJECTIVETo explore a new method for the repair of the scar in the midface.

METHODSParallel juxtaposed expansion of the skin and soft-tissue of jaw, face, neck and posterior aspect of auricle was performed to repair the scar in the midface of 15 patients. The operation consisted of two steps. In the first step, two expanders were placed subcutaneously under the subskin of jaw, face, neck and posterior aspect of the auricle, respectively, and they were expanded timely to create adequate superfluous skin and soft tissue. In the second step, the expanded skin flap was rotated and advanced to repair the the scar in the midface.

RESULTSParallel juxtaposed expansion was performed to repair the scar in the midface of 15 patients. The incision was comparatively concealed, the colour and elasticity of the skin transplant, and the facial contours were satisfactory.

CONCLUSIONParallel juxtaposed expansion of the skin soft-tissue of jaw, face, neck and posterior auricular is beneficial for the repair of the scar in the midface.

Adolescent ; Adult ; Cicatrix ; surgery ; Face ; surgery ; Female ; Humans ; Male ; Skin Transplantation ; Surgical Flaps ; Tissue Expansion ; methods ; Tissue Expansion Devices

OBJECTIVETo investigate the feasibility and advantages of total auricular reconstruction with single big expander at dual plane through incision at remnant ear.

METHODS52 patients with microtia were treated. Through incision at remnant ear, one big expander (150 ml) was implanted in the post-auricular area beneath the superficial facial in the hairless area, and above the superficial fascia in the area with hair. In the second stage, total auricular was reconstructed with autologous cartilage framework and expanded skin. Skin graft was not necessary. Another 32 paitents with single big expander above the superficial fascia were used as control. The downward shift distance of expanders, the appearance of auriculocephalic sulcus and complication were recorded in order to assess the effect of these two methods.

RESULTSThe downward shift distance of expanders in the dual plane group (0.7 ± 0.3) cm were lower than that in the control group (1.3 ± 0.4) cm, showing significant difference (P < 0.05). After a follow-up period of 6-12 months, shallow auriculocephalic sulcus was presented in 5 patients of the dual plane group and 12 patient of the control group. The shallow auriculocephalic sulcus was cut to make it deeper and covered with full skin graft.

CONCLUSIONSDual plane skin expansion could reduce the downward shift distance of expander. Adequate skin on the upper part of expander could make satisfactory auriculocephalic sulcus.

Cartilage ; transplantation ; Congenital Microtia ; surgery ; Feasibility Studies ; Hair ; Humans ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Subcutaneous Tissue ; Surgical Flaps ; trends ; Tissue Expansion ; methods ; Tissue Expansion Devices

Over the last two decades, several tissue clearing methodologies have been established that render tissues optically transparent and allow imaging of unsectioned tissues of significant volumes, thus improving the capacity to study the relationships between cell and 3D tissue architecture. Despite these technical advances, the important unsolved challenges that these methods face include complexity, time, consistency of tissue size before and after clearing, and ability to immunolabel various antibodies in cleared tissue. Here, we established very simple and fast tissue clearing protocol, FxClear, which involves acrylamide-free electrophoretic tissue clearing (ETC). By removal of the acrylamide infusion step, we were able to achieve fast reaction time, smaller tissue expansion, and higher immunoreactivity. Especially, immunoreactivity and fluorescence intensity were increased in FxClear-processed tissues compared to un-cleared tissues. Our protocol may be suitable for small-sized biopsy samples for 3D pathological examinations.
Acrylamide ; Antibodies ; Biopsy ; Fluorescence ; Immunohistochemistry ; Methods ; Reaction Time ; Tissue Engineering ; Tissue Expansion

OBJECTIVETo comparatively study the difference of the skin expansion rate and instantly expanded skin retraction rate between implantation of double overlapping expanders and implantation of one single expander.

METHODSFrom Mar. 2009 to Mar. 2012, 22 cases with 39 sites for skin expansion, received double overlapping expanders in 24 sites, single expander in 15 sites. The area of original skin and expanded skin was measured by "wet-cloth sampling". Then the skin expansion rate was calculated. A distance of 5 cm at the center of expanded skin was re-measured after taking out the expanders. Then the instantly skin retraction rate was calculated.

RESULTSDuring the same expansion period, the skin expansion rate was (3.5 +/- 0.9)% with the double overlapping expanders and (2.6 +/-0.6)% with one single expander, showing a significant difference between the two groups (P = 0. 002), while the instantly skin retraction rate was not statistically different [(30.3 +/- 0.8)% vs (32.3 +/- 0.9)%; P = 0.47)]. There was a negative relationship between the instantly skin retraction rate and the expansion period (r = -0.768).

CONCLUSIONSThe skin expansion rate can be increased with double overlapping expanders, while the instantly skin retraction rate doesn' t decrease. So the skin expansion efficiency is increased to reduce the re-expansion times for the patients with large lesions.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; instrumentation ; methods ; Tissue Expansion ; instrumentation ; methods ; Tissue Expansion Devices ; Young Adult

OBJECTIVETo investigate a method of auricular reconstruction by soft tissue expansion techniques without skin grafting.

METHODSTwo tissue expanders (50 ml and 70 ml) were implanted under the skin of mastoid in 15 patients with grade II or III microtia. One big expander (100 ml) were implanted under the skin of mastoid in 13 patients with grade I microtia and 3 patients with grade II or III microtia. After skin expansion, the expanders were taken out. The autologous rib cartilage or Medpor scaffolds were implanted. The superior expanded skin flap was used to cover the frontal surface and the upper part of the back surface of the framework. The inferior expanded skin flap was transplanted to cover the lower part of the back surface of the framework. The remained expanded skin flap was transplanted to cover the wound in the lateral of head.

RESULTSNo skin graft was needed in all the patients. Epidermis blister occurred at the distal part of flap in one case. No other complication was happened. A follow-up of 6 to 12 months (mean 10.9 months) was carried out in all patients with good cosmetic result when the reconstructed ear underwent second-stage operation. The scar size on the dornor site was (5.2 +/- 0.6) cm2 The satisfactory rate was 90% (28/31).

CONCLUSIONSThe expanded skin with this new method is enough for auricular reconstruction without skin grafting, leaving less complication and less scar at donor site.

Adolescent ; Dermatologic Surgical Procedures ; methods ; Ear Auricle ; surgery ; Humans ; Mastoid ; Polyethylenes ; Skin Transplantation ; Surgical Flaps ; transplantation ; Tissue Expansion ; methods ; Tissue Expansion Devices