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The Effect of Tissue Expansion on Previously Irradiated Skin
William J. Kane, MD;
Thomas V. McCaffrey, MD, PhD;
Thomas D. Wang, MD;
Thomas M. Koval, PhD
Arch Otolaryngol Head Neck Surg. 1992;118(4):419-426.
Abstract
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• Opinion remains divided over the advisability of tissue expansion in previously irradiated skin. We examined the properties of, and complications associated with, tissue expansion in previously irradiated rabbit scalps. Irradiation injury was produced using fractionated roentgen rays, with a total dose of 5000 cGy over a 5-week interval. Following a 20-week convalescence interval, expansion was incrementally conducted over 4 weeks. Monitored parameters included cutaneous perfusion as indicated by fiberoptic dermofluorometry, intraluminal pressure, linear surface gain, and area of surface necrosis. The incidence and severity of complications, including surface necrosis, were significantly higher among irradiated animals. Furthermore, the overlying skin of irradiated animals demonstrated a significantly decreased compliance and measurable area gain. Given the inferior expandability and higher tendency toward complications with contemporary expansion techniques in previously irradiated skin, alternate reconstructive options are preferable in this setting.
(Arch Otolaryngol Head Neck Surg. 1992;118:419-426)
Author Affiliations
From the Departments of Otorhinolaryngology–Head and Neck Surgery (Drs Kane, McCaffrey, and Wang) and Radiation Oncology (Dr Koval), Mayo Graduate School of Medicine, Mayo Foundation, Rochester, Minn.
Footnotes
Accepted for publication October 17, 1991.
Presented at The Combined Otolaryngology Spring Meeting Before The American Academy of Facial Plastic and Reconstructive Surgery, May 3, 1991, Waikaloa, Hawaii.
Reprint requests to Department of Otorhinolaryngology–Head and Neck Surgery, Mayo Graduate School of Medicine, 201 First St SW, Rochester, MN 55905 (Dr McCaffrey).
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