The role of osmotic self-inflatable tissue expanders in intestinal transplant candidates
| Autor: | Jacques Pirenne, Marc Miserez, Diethard Monbaliu, Nathalie P. Deferm, Francesca Maione, Laurens J. Ceulemans |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Adult
medicine.medical_specialty Percutaneous 030230 surgery 03 medical and health sciences 0302 clinical medicine Hematoma medicine Humans Complication rate Child Tissue expander Transplantation business.industry Tissue Expansion Devices Fascia medicine.disease Surgery Intestines medicine.anatomical_structure Inflatable 030211 gastroenterology & hepatology Female business |
| Popis: | Intestinal transplantation (ITx) is often associated with decreased abdominal domain, rendering abdominal closure difficult. Pre-transplant placement of tissue expanders (TE) can overcome this challenge; however it can be associated with life-threatening complications. This review aimed to comprehensively summarize all available literature on TE in ITx candidates and include the technical details of osmotic, self-inflatable TE -a technique undescribed before. PubMed, EMBASE and CCTR were searched until April 30, 2016. Based on structured data abstraction and detailed analysis, eighteen cases of TE (inflatable) in ITx candidates were found. Localisation of placement was: subcutaneously in 11; intraperitoneally in 4; 1 patient had 1 TE placed retromuscularly and 1 intraperitoneally; 1 patient had biplanar TE (intraperitoneally placed and extending retromuscularly) and in 1 localisation was unreported. Complication rate was high (61%), injection- or intraperitoneal-related, resulting in life-threatening infections/hematoma. With successful expansion, physiological graft protection -by skin+/-fascia- was always achieved. In completion of this review, we describe our own experience with two patients (7.5-, 34-year-old females), in whom osmotic TE were placed subcutaneously pre-ITx. No TE-related complications occurred and both patients underwent uncomplicated ITx with respectively primary skin and skin + fascia closure. The pros and cons of each TE type and placement are discussed, resulting in the overall conclusions that TE offer an important benefit in graft-protection following ITx. Osmotic TE are safer than conventional prostheses by avoiding percutaneous injections. Subcutaneous placement seems to be safer and more reliable. publisher: Elsevier articletitle: The role of osmotic self-inflatable tissue expanders in intestinal transplant candidates journaltitle: Transplantation Reviews articlelink: http://dx.doi.org/10.1016/j.trre.2016.07.002 content_type: article copyright: © 2016 Elsevier Inc. All rights reserved. ispartof: Transplantation Reviews vol:30 issue:4 pages:212-217 ispartof: location:United States status: published |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|