Nowadays, tissue expansion became the one of the most popular technique in the field of plastic surgery since it was first introduced by Dr. Neumann, who attempted an ear reconstruction using a latex balloon with a valve and a connector tube lying outside the skin in 1957 and Radovan, who introduced more safer and controllable soft tissue expansion.
In this paper, we would like to discuss the differences and technical considerations in the reconstruction of extremities comparing with that of the head and neck or trunk, through the experiences of 43 cases of upper and lower extremity reconstructions using soft tissue expansion from December, 1985 to July, 1988 in 35 patients.
Followings are the conclusions that we have decided from the 43 cases of extremity reconstruction using soft tissue expansion.
1) The site of expander insertion should be determined by considering the relationships between the lesion and the clinically available donor site. In extremities, it is better to insert the expander in the mediolateral sides rather than in the cephalad-caudad position.
2) The Z-plasties or Limberg flaps of the expanded tissue can be used successfully as well as the simple advancement flap without any problem. It is important to determine which type of local flap is the best choice for the case.
3) The incision may be placed intralesionally or just beside the deformity.
4) Expander be placed subcutaneously above the muscle fascia.
5) The main vasculatures or nerves which are exposed during the dissection are better placed
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