OBJECTIVE: To explore the application value of dual chamber round tissue expander in immediate breast reconstruction. METHODS: Sixteen patients, who had been provided immediate tissue expander/implant two-stage breast reconstruction using dual chamber round tissue expander in our hospital from March 2022 to October 2023, were involved in this study, and the relevant information was analyzed retrospectively. The overall design of the expander is a round shape, consisting of two equally divided semi-circular chambers. The two expansion chambers are connected by a silicone pad below and are respectively connected to their own water injection tubes. Both chambers are designed to expand unidirectionally towards the surface. The expansion principle, insertion process, and type of expander selection were investigated. The expansion effect and incidence of complications were summarized. The aesthetic effect of reconstructed breasts was evaluated from three aspects after stage Ⅱ surgery: the position of infra mammary fold, the breast protrusion, and the breast volume. RESULTS: Among sixteen patients in this study, three patients were selected with the type of 400 mL expander and thirteen patients were given the type of 600 mL expander. The median time of tissue expansion was 4.0 (2.0, 5.0) months, with an average volume of expansion of (538.8±111.7) mL. The average expansion ratio of upper/lower chamber was 45.4%±8.4%. The position of the infra mammary fold needed not to be adjusted during the prosthesis exchange process. All the patients were applied anatomical prostheses, and the median volume of the prosthesis was 395 (345, 410) mL. One patient developed seroma during expansion period, who got improved after local aspiration. The average follow-up time was (9.0±3.6) months. 81.3% (13/16) of the patients achieved an aesthetic evaluation of "Good" in breast reconstruction, and 75.0% (12/16) of the patients got a grade Ⅰ or grade Ⅱ capsule contracture of the prosthesis. CONCLUSION The application of dual chamber round tissue expander could effectively dilate the lower pole of the breast, personalize the expansion ratio of the upper and lower poles of the breast, and avoid the displacement of the expander during the expansion period. Therefore, it could provide a good foundation for subsequent prosthesis exchange.
Humans ; Tissue Expansion Devices ; Female ; Mammaplasty/instrumentation* ; Tissue Expansion/instrumentation* ; Retrospective Studies ; Adult ; Middle Aged ; Breast Neoplasms/surgery* ; Breast Implants ; Mastectomy

Our objective was to evaluate the effectiveness of skin-stretching devices for closing defects on the extremities of dogs. Antebrachial skin defects were created on the limbs of 24 dogs randomly divided into three groups. Skin stretchers included staples and sutures passing through them (group A), sutures and hypodermic needles (group B), and Pavletic device (group C). Wounds on the left were further undermined in all groups. Tension and blood perfusion were assessed. After removing the stretchers on day 3, the defects were sutured and wound healing was clinically scored. Histological variables evaluated were cellular infiltration, edema, collagen orientation, and thickness of epidermis. Significant differences in tension were found among groups (p < 0.0005) and between measurement times for undermined (p = 0.001) or non-undermined (p < 0.0005) wounds. In contrast, blood perfusion values did not differ significantly. Clinical scores for group B seemed to be better than those for groups A and C, but differences were not significant. Primary wound closure using the Pavletic device was not feasible. No significant differences in histological variables were found between groups. Skin stretching with staples or hypodermic needles resulted in successful wound management with minor side effects on skin histology and circulation.
Animals ; Dogs ; Female ; Forelimb/pathology ; Male ; Skin/*injuries ; Stress, Mechanical ; Tissue Expansion/instrumentation/*veterinary ; Wound Closure Techniques/instrumentation/*veterinary ; Wound Healing/physiology

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

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

OBJECTIVETo test the efficacy of kyphoplasty using an enhanced balloon expander in restoring the height of vertebral compression fractures (OVCF).

METHODSFifteen lumbar vertebral bodies (L1-L5) were harvested from 3 young male fresh cadavers and separated into individual vertebral bodies with the bilateral pedicles of the vertebral arch removed. Before operation, plain X-ray films of all the vertebral bodies were obtained. All the vertebral bodies were compressed lengthwise to approximately 80% of their original heights using a universal material-testing machine to result in compression fractures. Post-compression vertebral bodies were then repaired using an enhanced balloon expander, and the delivery of the bone cement into the vertebral bodies was observed. The heights of the anterior and posterior borders of the vertebral bodied were measured before and after compression as well as after kyphoplasty.

RESULTSThe inflation of the balloon expander averaged 2.95-/+0.18 ml and the pressure was 122.67-/+27.89 psi (1 psi=6895 Pa). Kyphoplasty resulted in significant restoration of the vertebral body height lost due to the compression (P<0.01).

CONCLUSIONKyphoplasty using an enhanced balloon expander may restore vertebral body height damaged by compression and correct the kyphotic deformity. The balloon expander can be a effective and economic choice for kyphoplasty for its relatively low cost.

Adult ; Bone Cements ; Cadaver ; Catheterization ; Fractures, Compression ; etiology ; surgery ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Spinal Fractures ; complications ; surgery ; Tissue Expansion Devices ; Vertebroplasty ; instrumentation ; methods

OBJECTIVETo compare the clinical results of balloon percutaneous kyphoplasty (PKP) and "Sky-bone expander" PKP.

METHODSFrom October 2004 to February 2006, 25 cases (57 vertebrae) balloon PKP and 24 cases (29 vertebrae) "Sky-bone expander" PKP procedures were performed. The operation time, bleeding volume, cement injected volume were recorded during operation. The patients' pain relief and functional activities recovery were evaluated after operation. The distribution of the cement and the restoration of vertebral height were also observed post-operation. All these patients were followed-up by telephone or clinic consults after discharged.

RESULTSAll cases were successfully experienced procedures. There are no significant differences in operative time, bleeding volume and cost of every vertebrae in these two group (P > 0.05). The balloon group had larger cement injected volume per pedicle than Sky group (4.27 +/- 1.08) ml vs. (3.15 +/- 0.78) ml (P < 0.05). The VAS and ODI scoring of these two groups were both decreased significantly after operation. The vertebral height were restored in both two groups with anterior height and midline height restored significantly in balloon group and midline height restored significantly in Sky group. The cement distribution of "Sky-bone expander" PKP with unipediclar injection mostly limited in the injective side of the vertebral body, but most of the balloon PKP vertebrae with unipediclar injection can be seen a cross-midline cement distribution in the anterior-posterior position X ray film.

CONCLUSIONSBoth balloon PKP and "Sky-bone expander" PKP are efficacious and safety in the treatment of vertebral compression fractures. "Sky-bone expander" PKP is more suitable for single level compressive fracture while balloon PKP is especially suitable for multiple level compressive fractures.

Aged ; Aged, 80 and over ; Catheterization ; instrumentation ; Female ; Follow-Up Studies ; Fractures, Compression ; etiology ; surgery ; Humans ; Male ; Middle Aged ; Osteoporosis ; complications ; Spinal Fractures ; etiology ; surgery ; Tissue Expansion Devices ; Vertebroplasty ; instrumentation ; methods

OBJECTIVETo investigate the effect of local application of bFGF and sucralfate during continuous tissue expansion (CTE).

METHODSCTE combined with local administration of bFGF and sucralfate was used in twelve patients with scar and nasal tip defects. Twenty three expanders were placed in the subcutaneous pockets through intralesion short incisions. Continuous expansion began at 1-3 days after expander implantation. The histomorphological changes and epidermal cell proliferation were observed. The clinical results were investigated.

RESULTSThe average inflation time was 8.9 days. The average interval of the two operations was 13.5 days. The average hospitalization was 28.4 days. The average immediate stretch-back rate of the expanded skin was 25.7%. The clinical results were satisfactory without any complications. Histological examinations showed that the epidermal, granular and spinous layer became thicker. The basal cells increased significantly. The dermis thinned slightly and the collagen fibers became thicker. The elastic fiber regenerated significantly. Fibroblast and capillary density increased obviously. The immunohistochemistry analysis showed that the proliferation of epidemic basal cells was significant postoperatively.

CONCLUSIONLocal application of exogenous bFGF and sucralfate during CTE was feasible in patients. It could accelerate tissue expansion and improve the quality of expanded skin flap.

Capillaries ; anatomy & histology ; Cell Proliferation ; Collagen ; analysis ; Dermis ; blood supply ; pathology ; Epidermis ; cytology ; Fibroblast Growth Factors ; pharmacology ; Fibroblasts ; cytology ; Humans ; Length of Stay ; Nose Deformities, Acquired ; surgery ; Sucralfate ; pharmacology ; Surgical Flaps ; blood supply ; Time Factors ; Tissue Expansion ; instrumentation ; methods ; Tissue Expansion Devices ; Treatment Outcome