External tissue expansion using negative pressure in upper-extremity reconstruction

Soft-tissue expansion in the upper extremities is a valuable technique with increasing indications, which means that using of tissue expansion in reconstruction of upper limb increases day after day. Tissue expansion with implantable balloons is a fairly standard method in reconstructive surgery. This article describes the use of external tissue expansion by using negative pressure in soft-tissue reconstruction of the upper extremities in 40 patients. Valved cups (external expanders) were applied to the skin on one or both sides of the lesion. With the subsequent application of a negative pressure source to the valves, gradual tissue expansion occurred inside the external expanders. When there was enough surface area of the expanded skin to cover the exposed area after lesion excision, the expansion process was stopped and surgery was performed. The upper limit of negative pressure must not exceed -200 mbar. The complications were mild and mainly involved skin blistering. External tissue expansion using a negative pressure technique is simple, safe, cost effective, and associated with good results in the reconstruction of soft-tissue injuries.