Serial measurement of blood flow in expanded tissue by laser Doppler velocimetry

Histology and physiology of tissue expansion

BACKGROUND

Tissue expansion is a concept based on the skin's natural ability to stretch in response to an underlying force.

OBJECTIVE

The purpose of this article is to review the histological and physiological changes that occur within the soft tissue and underlying structures during tissue expansion.

METHODS

An extensive search of the literature reviewing these changes is summarized herein.

RESULTS

Conventional tissue expansion may result in epidermal hypertrophy, decreased dermal, muscle, and adipose thickness, and bone resorption. A vascular capsule and angiogenesis provides a highly vascular flap and improves flap viability. Few soft tissue changes occur during rapid tissue expansion. The ability of the skin to increase in surface area during conventional tissue expansion is primarily because of biological tissue creep. Rapid expansion may result from mechanical tissue creep.

CONCLUSION

Many soft tissue changes occur during tissue expansion. Most of these changes return to the pre-expansion state over time following discontinuation of the expansion process.

Cranio-maxillo-facial tissue expansion, experimentally based or clinically empiric? A review of the literature

The literature over 10 years covering tissue expansion in cranio-maxillo-facial surgery is reviewed. Since 1981, an evolving set of indications for application of the soft-tissue expansion technique has been published. However, it seems to be based much more on clinical experience (empiricism) than on the results of thorough experimental research. The direction of future research should be aimed at effects on bone, cartilage and mucosa at a microscopical level, and at the influence on growth and development of cranio-maxillo-facial structures.