The most common traditional tissue expanders that are in use have an integrated port which is used to inflate the expander with saline (the salty water that runs in your blood). Usually the expander is partly inflated with saline when it is inserted and then the wounds are allowed to heal for a few weeks before expansion begins.
Once this process is undertaken the patient comes back every week or two and has between 50-100 cc of saline inflated each time until it is finally inflated. The tissue expander port has a metal back on it which is used to halt the progress of the needle and allow easier finding with a magnet placed over the skin. It also has a self-sealing silicone outer layer which allows a needle to be passed through the skin and inflation begins.
Self inflating tissue expanders are an exciting new concepts and at present there are 2 types available in Australia.
The first is a polymer that is made of the same plastic as contact lenses. It is shrunk down and dehydrated and covered with a perforated silicone membrane which allows the body’s own serous fluid to rehydrate the plastic and this slowly inflates over a period of 8 – 12 weeks.
The second is the air expander which has the potential to revolutionise tissue expansion as we know it. It has a small canister of carbon dioxide which is released 10 mls at a time and is controlled by a remote control device. This device is easy to use and controlled by the patient and delivers 30 mls per day.
The advantages of these devices are that there are less doctor visits, no needles, and a less painful expansion as it is a more gradual process. The disadvantage is that there is no way to deflate the expander is required.
This article was brought to you by Dr Damien Grinsell.
