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Author(s): Nadeem Yousaf Muhammad Mustehsan Bashir Farid Ahmad Khan M.B.B.S, FCPS (Surg), FCPS( Plastic Surg), FCPS ( Plastic Surg) , FRCS(Edn)

Pages: 8-12 |

The use of tissue expender has become a popular and well established technique for soft tissue reconstruction. Infection is the most common and devastating complication, traditionally treated by removal of the infected implant. The study demonstrates the results of attempted salvage of infected expanders. This case series was done at department of Plastic surgery, KEMU, Lahore from Sep, 2006 to Aug, 2010. Medical record of all the patients undergoing reconstruction with tissue expanders was reviewed and cases complicated by infection of surgical site were selected for the study. Minor wound infections (presence of pain or tenderness, localised swelling, redness or heat and serous drainage from the incision singly or in any combination and involving the skin, subcutaneous tissue and fascia around the expander or filling port) were treated by temporarily stopping the expansion and starting antibiotics according to culture and sensitivity. Cases of major wound infection (purulent discharge with partial or total dehiscence of the wound and exposure of expander) were treated differently in each case. Twelve cases of tissue expansion out of 35 (34.28%) got infection. Eleven were salvaged successfully (91%). Seven cases had minor soft tissue infection and five cases had major form of infection. Cases of minor wound infection were all successfully salvaged at the expense of brief delay in expansion (average 3.5 weeks) till the settlement of infection. Two cases of purulent discharge from the port site were salvaged by exteriorizing the port and halting the expansion for two week. Three cases of major infection involving the expander had partial dehiscence of the wound with exposure of implant. Two of these cases were successfully salvaged. In conclusion successful salvage of infected tissue expander should be attempted with a reasonably goo outcome