Tissue expansion has become the procedure of choice to augment the reconstructive possibilities of many head and neck defects. The advantages of the use of expanded adjacent tissue with similar color, texture, and function often outweigh the time and inconvenience of the expansion process. Expansion has become fairly commonplace, indeed necessary, in many nasal and scalp reconstructions. This familiarity should not blind us to the precautions regarding its use. See April 1992 issue, p 419. Kane et al1 in their article dealing with tissue expansion of previously irradiated skin make the compelling argument that alternate reconstructive techniques are preferable in this setting. In their rabbit scalp model expansion in radiated tissue was associated with reduced tissue compliance (expandability), diminished vascular supply, and an increased rate of complications, notably tissue necrosis. In fact, tissue irradiated to a biologic dose of 5500 to 7000 cGy would be expected to be a
Kane W, McCaffrey TV, Wang TD, Koval TM, Shimotakahara SG, Larrabee WF. The Effect of Tissue Expansion on Previously Irradiated Skin. Arch Otolaryngol Head Neck Surg. 1992;118(5):534–535. doi:10.1001/archotol.1992.01880050088021
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