Tissue expansion

Tissue expansion, first used clinically in 1957, has become part of the reconstructive surgeon's basic armamentarium. Though the devices used for expansion are now available in a variety of sizes and shapes, the underlying principle of graduated expansion of adjacent tissue by an inflatable device prior to transfer has not changed. Significant developments over the past year include an improved histologic understanding of the effects of expanders on their adjacent tissue, the use of expanders with prefabricated flaps and peripheral nerves, and case reports of the effectiveness of expanders in unusual reconstructive challenges. These topics are reviewed with regard to the recent literature.