Study of Tissue Expansion in the Reconstruction of Nevus and Scars

For management of nevus & various scars various methods are described like excision, skin grafting, dermabrasion, flap cover, dermatraction etc. but reconstruction of various scars by tissue expansion is a novel procedure. Aims & objectives: 1.Study of tissue expansion in the reconstruction of nevus & scars. 2. Advantage & disadvantages of tissue expansion. 3. Complications of tissue expansion. Methods: The study was conducted in SCB MCH, dept of Plastic surgery from October 2015 to April 2018. No. of patients in this study were 41 which includes post burn scars, post traumatic scars & nevus. Results: study includes age group from 11- 42 yrs with female predominance. It mainly includes post burn scars, facial scars. Neck was the most common site of expander used. Expander mostly used were rectangular type. Volume ranges from 50 to 540ml. Of total 46 expanders 5 cases two expanders used. Various complications of expanders included infection, blebs, hematoma, wound dehiscence etc of which extrusion of expanders were most common. Complications were more common in extremities. HTS & partial skin necrosis common scar related complication. Conclusion: Tissue expansion is an excellent technique to treat scars, pigmented lesions and alopetic patches. This provides the best tissue quality and matching as regards tissue characteristics. Flaps and skin grafts are inferior in treatment of these lesions when tissue expansion is possible. However this technique has its complications like infection, exposure and failure of expander. Therefore proper planning and selection of expander is extremely important.

Surgical Treatment of Foot Ulcer in Hansen's Disease / 나학회지

Damages to the sensory, autonomic and motor nerves in leprosy patients are followed by anesthesia, dryness of the skin and muscular paralysis. Most plantar ulcers in leprosy patients are caused by repetitive moderate stress. Minor injuries such as bruising sustained as a result of the misuse of anesthetic limbs may lead to ulceration, scar formation and secondary infection. Cellulitis develops and destroys subcutaneous tissue, resulting in an infection which can reach the bone. As a result of osteomyelitis, bone is absorbed, sequestra are extruded and the architecture of the foot is destructed. The most common sites of the plantar ulceration are over the metatarsal heads, the base of the fifth metatarsal, the base of the proximal phalanx, and the calcaneus. During the past 9 years, we treated 85 patients with ulcers located on the sole and the dorsum of the foot, and lower third of the leg. To prevent osteomyelitis and amputation of the lower leg, we performed various treatment modalities such as free and pedicle flaps, skin grafts, and mechanical stretching devices of the skin (e.g., Sure Closure, Proxiderm, etc), as well as consistent vacuum-assisted closure. We obtained satisfactory results in most cases. We report detailed results and related references.