Use of tissue expansion in revision of unhealed below-knee amputation stumps

When local tissue is insufficient for the revision of unhealed below-knee s tumps tissue expansion offers an interesting alternative for local coverage . We used this method in seven patients (five men, two women; mean age 30 y ears) who had had below-knee amputations, six of them after injury to a hea lthy limb and one for purpura fulminans. Ten tissue expanders were inflated slowly and intermittently either weekly or twice weekly depending on the p atients. The mean expansion period was 92 days. Mean hospital stay for the two operations was 5.8 (range 4-9) and 7.6 (range 6-10) days, respectively. Using subjective and objective criteria, functional outcome was excellent in five patients and good in one. Expansion failed in one because of infect ion. Expanded skin Raps allow good cover with a minimal scar area in approp riate cases, while preserving the skin sensitivity and length of the tibial shaft.