Maximising the use of tissue expanded flaps

Tissue expansion offers the advantages of supplying tissue similar in texture and colour to the defect to be covered. However, to maximise the result, the expanded tissue must be used in the most efficient way possible. Rectangular expanders have been shown to yield the most available tissue. A technique to maximise the use of expanded tissue with a rectangular tissue expander is described. The technique is one of an advancement flap that maximises the use of expanded tissue in both a vertical and horizontal direction by adding backcuts to the sides (and interposing triangles of local tissue into these backcuts) as well as the base of the flap. This technique has been successfully applied to 11 children (17 expanders) undergoing tissue expansion during a 19 month period.