ABSTRACT
Tissue expander design in breast reconstruction has evolved substantially over the last 60 years. An insightful appreciation of breast aesthetics, coupled with competition among industry partners, has resulted in innovative and disruptive technology to benefit patients desiring immediate reconstruction following mastectomy. In this article, we discuss the evolution of breast expander technology and the implications in improving patient outcomes in breast reconstruction.
Subject(s)
Equipment Design , Mammaplasty/methods , Tissue Expansion Devices , Tissue Expansion/methods , Equipment Design/history , Female , History, 20th Century , History, 21st Century , Humans , Mammaplasty/history , Tissue Expansion/historyABSTRACT
Cicero Parker Meek (1914-1979) was working as a general practitioner at the Aiken County Hospital in South Carolina, USA, and had a special interest in the treatment of burn patients. The procedure first presented in 1958 by Meek for a device-based expansion of split-skin (micrografting), which was invented before the mesh technique, is a milestone in the history of burns surgery. The method was forgotten until well into the 90s of the last century, and was only readopted and improved by no longer identifiable physicians at the Red Cross Hospital in Beverwijk. The Meek translation procedure was subsequently modified through the innovations of Kreis and Raff. With increased survival of massively burned patients, mesh grafting fell short of requirements. Mesh grafts of 1:9 expansion are difficult to handle and are vulnerable to dislodgement on the wound bed. Kreis and Raff showed in 1994 that 1:9 expanded mesh grafts did not achieve a true 1:9 expansion on the wound surface, in contrast to 1:9 expanded Meek grafts. Thus Meek grafts provided a highly effective autograft expansion in very large burns. Cicero Parker Meek was an exceptional person in the history of burn therapy.
Subject(s)
Burns/surgery , General Practice/history , Skin Transplantation/history , Tissue Expansion/history , History, 20th Century , Skin Transplantation/instrumentation , Tissue Expansion/instrumentationSubject(s)
Plastic Surgery Procedures/history , Surgical Flaps/history , Tissue Expansion Devices/history , History, 20th Century , History, 21st Century , Humans , Plastic Surgery Procedures/instrumentation , South Africa , Tissue Expansion/history , Tissue Expansion/instrumentation , United StatesABSTRACT
The history of skin gaining techniques, concerns suture, skin extension and skin expansion. Although, for a very long time, suture and skin extension were intimately related and constitute the basis for current techniques, it was only from the second part of the 20th century that skin expansion was developed and that skin extension was submitted to specific studies.
Subject(s)
Dermatologic Surgical Procedures , Suture Techniques/history , Tissue Expansion/history , History, 15th Century , History, 16th Century , History, 17th Century , History, 18th Century , History, 19th Century , History, 20th Century , History, Ancient , History, Medieval , History, Modern 1601- , HumansABSTRACT
BACKGROUND: Tissue expansion has become a widely used adjunct in reconstruction of the skin. OBJECTIVE: To trace the history of the concept of tissue expansion from the ancient to the latest medical literature. METHODS: We reviewed the technologic developments in the materials and methods of tissue expansion. RESULTS: Tissue expansion is of clinical importance and can be understood by the biochemical, biomechanical, and histologic features of expanded skin. CONCLUSION: Tissue expansion is becoming widely used and accepted and its continued use under many circumstances is justified by the experimental and clinical results.
