Surgical treatment of children with scars on the lower leg and in the area of Achilles tendon using expander dermatension

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Abstract

Treatment of scar deformities of shin and ankle is traditionally a challenge due to significant functional load to the segment and the surface location of the Achilles tendon. Published data indicates that the use of expander dermotension of shin is not widespread and poorly covered in the literature [6]. Available data in the literature devoted to the expander dermotension of shin, are characterized by individual observations. There are no clear guidelines for size selection of the expander, for the protocol of its filling and postoperative regime. The purpose was to study the peculiarities of tissue dermotension of shin and development of recommendations for the use of this method to recover the full skin of shin and area of the Achilles tendon. Materials and Methods. Full restoration of the skin on the leg in the area of the Achilles tendon using tissue dermotension was performed in 24 patients in the clinic of Turner Scientific and Research Institute for Children’s Orthopedics from 2009 to 2014. To perform dermotension we used tissue expanders Eurosilicone (France), st. reg. № FSZ 2010/07171 from 09.06.2010; atraumatic suture material. Results. Complications amounted to 12.5% of all observations, and included: migration of port expander, marginal necrosis on line surgical suture and transient swelling of the foot. Efficacy of treatment was evaluated according to the following criteria: 1) the restoration of full cover in the region of the scar deformation; 2) elimination of adhesions, restore slip anatomical structures; 3) the increase of the amplitude of motion of the ankle joint. All patients achieved clinical improvement 2-3 criteria that considered a good result. Complications did not have a significant impact on the final result of the treatment. Conclusions: 1. Expandera dermatensia is an effective way to full recovery of the skin on the calf and the Achilles tendon. 2. Capsule forming around the expander and part of the flap, which helps eliminate adhesions and restoring slip anatomical structures and to increase range of motion in the ankle joint.

About the authors

O. V. Filippova

Turner Scientific and Research Institute for Children’s Orthopedics

Author for correspondence.
Email: noemail@neicon.ru
Russian Federation

A. G. Baindurashvili

Turner Scientific and Research Institute for Children’s Orthopedics

Email: noemail@neicon.ru
Russian Federation

K. A. Afonichev

Turner Scientific and Research Institute for Children’s Orthopedics

Email: noemail@neicon.ru
Russian Federation

R. V. Vashetko

St. Petersburg I.I. Dzhanelidze Research Institute of Emergency Medicine

Email: noemail@neicon.ru
Russian Federation

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