Reconstruction in plastic surgery using osmotic tissue expanders

BACKGROUND: Tissue expander is a major reconstructive modality. Its main disadvantages include: long and inconvenient period of inflation with temporary deformity of the surrounding tissue. Osmotic expander was developed in order to eliminate some of these limitations. It is a self-filling device which absorbs fluids in order to achieve tissue expansion faster.

PURPOSE: We present our experience with 28 consecutive cases of tissue reconstruction using osmotic expanders. We wish to emphasize the main advantages and limitations of this device.

METHODS: The present study was launched in May 2008, until April 2014, for twenty eight patients, median age 26 years with reconstructions using an osmotic expander (total of 35 expanders). The reasons for using tissue expander included large congenital nevi (75%) and scars.

RESULTS: In all of the cases, the operative and post-operative management was uneventful. During the expansion period, there were 2 outpatient clinical visits. The average expansion time was 9 weeks. In 11% (three patients) there was partial extrusion of the expander. In all other cases there were no complications and the final aesthetic results were satisfying.

DISCUSSION: Osmotic expander is an advanced modality for tissue reconstruction. The final shape and size are precisely predictable. Its initial small size allows for a small surgical incision and short overall operating time. The expansion period is shorter and more convenient for the patient. Its main disadvantage includes the inability to control the filling rate and the need to remove the expander in case of damage to the overlying tissue.

CONCLUSION: Osmotic expander is a reliable tool for tissue expansion. It allows for a satisfying aesthetic result in a shorter period of time and with less inconvenience to the patient.