INDICATIONS AND RESULTS OF TISSUE EXPANSION IN A PLASTIC SURGERY DEPARTMENT IN SUB-SAHARAN AFRICA | ||
| The Egyptian Journal of Plastic and Reconstructive Surgery | ||
| Articles in Press, Accepted Manuscript, Available Online from 19 November 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejprs.2025.437915.1454 | ||
| Authors | ||
| DJE BI DJE ASSI Valérie* 1; ALLAH KONAN Christophe2; SOUMARO Kanate Daouda2; SIE ESSOH Jean Baptiste2; KOSSOKO Hippolyte3 | ||
| 1UNIVERSITY FELIX HOUPHOUET BOIGNY DE COCODY (COTE D'IVOIRE) | ||
| 2UNIVERSITY FELIX HOUPHOUET BOIGNY de COCODY | ||
| 3UNIVERSITY FELIX HOUPHOUET BOIGNY | ||
| Abstract | ||
| ABSTRACT Introduction: Tissue expansion is a technique whose prohibitive financial cost makes its use selective in West Africa, where resources are limited. The aim of this study was to describe the indications and results of this technique performed in a plastic surgery department in Côte d'Ivoire. Patients and methods: A cross-sectional observational study was conducted over a duration of 27 years. The variables studied included etiologies, expanders, reconstruction, complications, overall results, and imperfections. Descriptive statistics were performed. Results: Data were collected in 36 patients who underwent 45 expansion procedures with 50 expanders. The median age was 25 years (Q1=12 - Q3=32). There were eleven men and 25 women. The etiologies were classified as acquired lesions (n=13/36), burn sequelae (n=10/36) and congenital conditions (n=13/36). Implantation sites of the 50 expanders were the cephalic extremity (n=13/50), the trunk (n=18/50) and the limbs (n=19/50). Twenty-five patients had a single expander. The median volume was 800 ml (Q1=250 - Q3=1000). The median duration of expansion was 9 weeks (Q1=8 – Q3=10). Out of the 45 expansion procedures, 36 resulted in reconstruction in 30 patients with 40 expanders. The reconstruction methods were an expanded flap (n=18/36), an expanded full-thickness skin graft (n=11/36), breast implant reconstruction (n=4/36) and excision-suture (n=3/36). Nine procedures carried out in six patients were unsuccessful. During the 45 expansion procedures 17 complications occurred in 12 patients. The median follow-up duration was 15 years (Q1=1-Q3=24). The overall results for all patients were satisfactory (n=22/36; 61%), fair (n=8/36; 22%), and poor (n=6/36; 17%). Conclusion: In this study, the indications for tissue expansion were burn sequelae, acquired lesions, and congenital conditions. This technique enabled reconstruction in 80% of patients. Failures of the procedure were in limbs. This experience should encourage the routine use of tissue expansion techniques. However, it is essential to lobby laboratories is essential to make the cost of expanders affordable for countries with limited resources. | ||
| Keywords | ||
| Expander; Reconstructive surgery; Resource limited countries; Skin expansion | ||
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