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Use of an aspiration cannula for rapid deflation of tissue expander
burns 34 (2008) 139–140
available at www.sciencedirect.com
journal homepage: www.elsevier.com/locate/burns
Letter to the Editor
Use of an aspiration cannula for rapid deflation of tissue expander Tissue expansion has become a major reconstructive modality for a wide variety of soft-tissue defects over the past 30 years. The technique of tissue expansion can be used in a number of clinical applications wherever soft tissue coverage is needed in reconstructive surgery. While it allows the reconstruction of defects with neighboring tissue of similar color, texture, sensation, thickness, and hair-bearing capability, donor site morbidity is avoided [1–3]. Tissue expansion has greatly facilitated reconstruction of particularly large burn deformities of the trunk that may require multiple serial expansions to be carried out because of the large area to be covered. In such cases, as in our patients, expanders of 1000 ml volume are placed bilaterally and are expanded to over 2000 ml without difficulty [3–5] (Fig. 1). In each subsequent inflation, saline is injected into the implant through a 23-gauge, or smaller butterfly needle inserted percutaneously into the filling port. It is useful
connecting the needle with a syringe through a short piece of tubing in order to prevent the dislocation of the needle during each filling [3]. It is time and effort consuming procedure if deflation of the expander is performed in the same way during the removal of the expander, especially even the expander’s volume is larger and placed bilaterally. In these cases, we deflate the expander through a 21-gauge, or larger needle inserted into the filling port and connected the needle to a aspiration cannula. We spend less time and effort with the aspiration of the saline via expander. We have been using this method for many years because it shortens the operation time and it facilitates the deflation of the expander. Therefore, we offer the use of this method. Although, in the textbooks the inflation of the expander was described properly, there is no available information about the deflation. With the method we mentioned above, we aim to contribute to the armamentarium of the surgeon.
Fig. 1 – Following completion of expansion with two tissue expanders. Note the expanders larger volumes (left side). The method of deflation of the expander mentioned above (middle). Intraoperative view following deflation of expander (right side).
140
burns 34 (2008) 139–140
references
[1] Austad ED. The origin of expanded tissue. Clin Plast Surg 1987;14:431–3. [2] Vander Kolk CA, McCann JJ, Knight KR, O’Brien BM. Some further characteristics of expanded tissue. Clin Plast Surg 1987;14:447–53. [3] Argenta LC, Marks MW. Principles of tissue expansion. In: Mathes SJ, editor. Plastic surgery. Philadelphia: SaundersElsevier; 2006. p. 539–67. [4] Marks MW, Argenta LC, Thornton JW. Burn management: the role of tissue expansion. Clin Plast Surg 1987;14:543–8. [5] Di Mascio D, Castagnetti F, Mazzeo F, Caleffi E, Dominici C. Overexpansion technique in burn scar management. Burns 2006;32:490–8.
Selma So¨nmez Ergu¨n* Department of Plastic and Reconstructive Surgery, Vakıf Gureba Hospital, Istanbul, Turkey
¨ zcan R. Hakan O Department of Plastic and Reconstructive Surgery, Pamukkale Medical School, Denizli, Turkey *Corresponding author at: Bahc¸es¸ehir Emlak Bankası Konutları, B 18 D3 C020403, 34 900 Bu¨yu¨kc¸ekmece, Istanbul, Turkey. Tel.: +90 212 669 08 35; fax: +90 212 621 75 80 E-mail address: [email protected] (S.S. Ergu¨n) 0305-4179/$34.00 # 2007 Elsevier Ltd and ISBI. All rights reserved. doi:10.1016/j.burns.2007.04.001
available at www.sciencedirect.com
journal homepage: www.elsevier.com/locate/burns
Letter to the Editor
Use of an aspiration cannula for rapid deflation of tissue expander Tissue expansion has become a major reconstructive modality for a wide variety of soft-tissue defects over the past 30 years. The technique of tissue expansion can be used in a number of clinical applications wherever soft tissue coverage is needed in reconstructive surgery. While it allows the reconstruction of defects with neighboring tissue of similar color, texture, sensation, thickness, and hair-bearing capability, donor site morbidity is avoided [1–3]. Tissue expansion has greatly facilitated reconstruction of particularly large burn deformities of the trunk that may require multiple serial expansions to be carried out because of the large area to be covered. In such cases, as in our patients, expanders of 1000 ml volume are placed bilaterally and are expanded to over 2000 ml without difficulty [3–5] (Fig. 1). In each subsequent inflation, saline is injected into the implant through a 23-gauge, or smaller butterfly needle inserted percutaneously into the filling port. It is useful
connecting the needle with a syringe through a short piece of tubing in order to prevent the dislocation of the needle during each filling [3]. It is time and effort consuming procedure if deflation of the expander is performed in the same way during the removal of the expander, especially even the expander’s volume is larger and placed bilaterally. In these cases, we deflate the expander through a 21-gauge, or larger needle inserted into the filling port and connected the needle to a aspiration cannula. We spend less time and effort with the aspiration of the saline via expander. We have been using this method for many years because it shortens the operation time and it facilitates the deflation of the expander. Therefore, we offer the use of this method. Although, in the textbooks the inflation of the expander was described properly, there is no available information about the deflation. With the method we mentioned above, we aim to contribute to the armamentarium of the surgeon.
Fig. 1 – Following completion of expansion with two tissue expanders. Note the expanders larger volumes (left side). The method of deflation of the expander mentioned above (middle). Intraoperative view following deflation of expander (right side).
140
burns 34 (2008) 139–140
references
[1] Austad ED. The origin of expanded tissue. Clin Plast Surg 1987;14:431–3. [2] Vander Kolk CA, McCann JJ, Knight KR, O’Brien BM. Some further characteristics of expanded tissue. Clin Plast Surg 1987;14:447–53. [3] Argenta LC, Marks MW. Principles of tissue expansion. In: Mathes SJ, editor. Plastic surgery. Philadelphia: SaundersElsevier; 2006. p. 539–67. [4] Marks MW, Argenta LC, Thornton JW. Burn management: the role of tissue expansion. Clin Plast Surg 1987;14:543–8. [5] Di Mascio D, Castagnetti F, Mazzeo F, Caleffi E, Dominici C. Overexpansion technique in burn scar management. Burns 2006;32:490–8.
Selma So¨nmez Ergu¨n* Department of Plastic and Reconstructive Surgery, Vakıf Gureba Hospital, Istanbul, Turkey
¨ zcan R. Hakan O Department of Plastic and Reconstructive Surgery, Pamukkale Medical School, Denizli, Turkey *Corresponding author at: Bahc¸es¸ehir Emlak Bankası Konutları, B 18 D3 C020403, 34 900 Bu¨yu¨kc¸ekmece, Istanbul, Turkey. Tel.: +90 212 669 08 35; fax: +90 212 621 75 80 E-mail address: [email protected] (S.S. Ergu¨n) 0305-4179/$34.00 # 2007 Elsevier Ltd and ISBI. All rights reserved. doi:10.1016/j.burns.2007.04.001