Simple Intraoperative Tissue Expansion with Gauze

Abstract

A common goal of plastic and reconstructive surgery is to provide ideal tissue replacement for defect with optimal aesthetic and functional results. Tissue expansion has been one of best methods that satisfies both aesthetic and functional requirements. But the need for chronic judicious expansion over many weeks and months has limited this use. Additional disadvantage of this technique is the cosmetic or functional deformity that may be associated with the buried expander and remote valve. Intraoperative expansion can be made the rapid skin expansion possible. This was useful method used for closing small skin defects with minimal tension or distortion. But previous intraoperative tissue expansion needs expansive tissue expander. Authors developed simple and inexpensive ISLE(Intraoperative Sustained Limited Expansion) technique without the use of tissue expander. Using consecutive gauze, tissue expansion was done. We could successfully repair 3-4cm wide soft tissue defect with this method. Before mass or scar excision, small incision was made at center of lesion. After the wide pocket undermined under incision, we put the maximum gauze into the pocket. Towel clip was used for temporarily approximation with cyclic and serial expansion. Skin lesion was completely excised and repaired with ease. We achieved good functional and cosmetic results from 34 patients over the last 18 months. Complications such as wound dehiscence, hematoma, flap necrosis were not noted.