Tissue expansion of free and pedicled flaps after transfer: possibilities and indications.

Journal Article (Journal Article)

Tissue expansion in combination with flap transfer has been widely reported as preexpansion of flaps, but only once as expansion of a free flap after transfer. Three free flaps and one pedicled flap were expanded after transfer. Indication, timing of expander implantation and explantation, technical aspects, and complications are reviewed. Indications for expander implantation after flap coverage were adjacent scar contracture, a secondary ulcer, or correction of contour deformity. The expander was placed as early as 4.5 months after free flap transfer. Low grade infection and seroma were complications necessitating early expander removal in two cases. The outcome was satisfactory in all four patients. Tissue expansion after flap transfer has been shown to be a reliable reconstructive option in selected cases. Indications are rare and include hypertrophic scar formation, scar contracture, secondary ulceration, or reconstructive procedures. In early free flap expansion, it is critical to avoid mechanical pressure of the pedicle. In musculocutaneous flaps, this can be accomplished by placing the expander subcutaneously. If more than 6 months have passed since transfer of the flap, the randomized blood supply is sufficient to place the expander anywhere under the flap.

Full Text

Duke Authors

Cited Authors

  • Baumeister, S; Follmar, KE; Erdmann, D; Baccarani, A; Levin, LS

Published Date

  • February 2007

Published In

Volume / Issue

  • 23 / 2

Start / End Page

  • 63 - 68

PubMed ID

  • 17330200

International Standard Serial Number (ISSN)

  • 0743-684X

Digital Object Identifier (DOI)

  • 10.1055/s-2007-970184


  • eng

Conference Location

  • United States