The use of tissue expanders in reconstructive surgery is now common. H
owever, the physiologic mechanisms by which expansion is achieved are
not well understood. A recent study demonstrated that rapid expansion
of skeletal muscle is accompanied by an increase in the number of sarc
omeres within a muscle fiber. This is in contrast to previous animal s
tudies whose results suggested that synthesis of sarcomere units was l
imited to the perinatal period. To further investigate potential incre
ases in sarcomeres and attempt to localize the active sites of sarcome
re synthesis, labeled adenosine (SH) was injected into rats during the
expansion of skeletal muscle. Adenosine was taken up by the muscle fi
bers and incorporated in the newly formed actin as part of light chain
s. An autoradiographic analysis of histologic sections of the expanded
muscle demonstrated a statistically significant increase in radioacti
vity within the expanded muscle. The distribution of the radioactivity
followed a proximal-to-distal gradient, with the proximal sections ex
hibiting more than 50 percent greater activity than the distal aspects
. These data suggest a preference for sarcomere synthesis in the proxi
mal portion of the expanding skeletal muscle. The significance of this
finding is uncertain. However, we suspect that sarcomere synthesis is
tension-dependent and likely to be related to local tension applied t
o a portion of the muscle fibers rather than to an anatomic site of pr
eference.