very good Ara I take it that the class has no more reactions. . .perhaps, they have been satisfied with your presentation. We may now close this forum. If there is a need to edit the initial papers you uploaded please do so, then print a copy, submit them to Prof. Butcon tomorrow.

Keep up the good work!

Tissue expander is widely used specially for plastic/cosmetic surgery purposes in the country. It is a treatment of choice for those with congenital and acquired defects in children and adults.

The indications for the use of this management are: burns (50%), Trauma (32%), Previous Surgery (9%). Despite these advantages, there are some pointed disadvantages with the use of tissue expanders. This include frequent visits for inflation, discomfort, and a period of increased deformity during time of infection. In the pediatric population, emotional disturbances may accompany the use of tissue expanders. Formation of a scar tissue capsule may result in reduced skin elasticity, and impeded flap movement and expanded skin has a tendency for post-operative retraction.

>>Cunha MS et al., 2002. Tissue Expanders Complications in Plastic Surgery: 10 Years Experience. Electronic version availalbe at http://www.scielo.br/pdf/rhc/v57n3/a02v57n3.pdf. Downloaded on September 3, 2009

I read that study at this site:[i]http://www.medbc.com/annals/review/vol_12/num_1/text/vol12n1p32.htm[/i]

hi ara

I've read about this study about Tissue expansion as an alternative way of reconstruction in cases of burns.

In the study they presented a case about a three year old Lebanon child with electric burn of the mouth, which he attained when he bit the male plug of a live extension cord connected to a private generator, an injury mechanism common to the majority of electric burns among children in Lebanon. The injury involved more than two-thirds of the lower lip as well as the tip of the tongue and parts of the upper lip and left oral commissure. The child was managed conservatively with frequent cleansing and topical antibiotic ointments until secondary healing was complete. He was then fitted with a dynamic splint constructed by a dental prosthodontist, which was worn for six months until the scars matured. The splint prevented the formation of severe microstomia and at the same time expanded the remaining normal lower lip segments. Secondary corrective surgery was specifically restricted to excision of the scar and primary approximation of the remaining lower lip lateral segments with a limited left commissuroplasty. Expansion of the lower lip was resumed post- operatively, using initially the same dynamic splint and subsequently an intraoral device, the anteroposterior projection of which was gradually increased. Satisfactory lower lip reconstruction was achieved with limited surgery, totally avoiding mutilation of surrounding normal tissues.

I was wondering if we have that in the Philippines?