RISK-FACTORS FOR COMPLICATIONS IN PEDIATRIC TISSUE EXPANSION

Tissue expansion in children has been associated with complication rat es of 20 to 40 percent. A critical analysis of 6 years' (1988-1993) ex perience with 180 expanders placed in 82 consecutive children was perf ormed to identify those factors which predispose to complications. Maj or and minor complications each occurred in 9 percent of patients. The factors associated with a statistically significant increase in compl ications were burns and soft-tissue loss, patient age under 7 years, u se of internal expander ports, and a history of two or more prior expa nsions. In addition, complications were significantly more likely to o ccur within the first 90 days than during any subsequent expansion. Fa ctors that did not influence complication rate included patient gender , wound drainage upon expander insertion or removal, intraoperative us e of antibiotic irrigation, number of expanders placed, use of customi zed expanders, and operating surgeon.