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June 11, 1982

Tissue expansion: 'future of plastic surgery for next 20 years'

JAMA. 1982;247(22):3039-3040. doi:10.1001/jama.1982.03320470005002

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New tissue stretching devices may enhance the ability of plastic surgeons to treat skin defects caused by trauma, cancer, or congenital events.

A two-step surgical technique, outlined by Eric D. Austad, MD, at a recent seminar in Chicago, utilizes expandable silicone shells or bags that are implanted subcutaneously to produce excess tissue around a site of injury. The shells are filled with sodium chloride so that inflation occurs via osmosis at a rate of 5 to 10 cc per day. After a six- to 12-week stretching period, the "balloons" are removed and the stretched skin used in a primary closure.

The procedure minimizes the problems inherent in grafting and muscle flap techniques, namely, skin color mismatch and trauma at the grafting site. By use of tissue expansion devices, natural physiological skin stretching mechanisms, like those that occur during weight gain or pregnancy, are mimicked.

In such natural processes, "skin or