January
2016 - Volume 137 - Issue 1 - p 31–35
Ascherman, J et al
Background: Implant-based breast reconstruction is the most
common reconstructive technique in the United States. Despite its popularity,
saline-based tissue expansion still has its limitations, including lengthy
expansion times, large uncomfortable bolus dosing, and frequent percutaneous
injections/expansion visits. Ideally, a novel technology would eliminate
frequent, percutaneous saline injections and allow patients to perform
expansion at home, reducing the disruptive experience of current tissue
expansion. Methods: Within the past 6 years, the AeroForm tissue expander
system has used remotely activated carbon dioxide release as the fill medium
instead of saline, eliminating many limitations of traditional tissue
expanders. In this article, the authors first review the relevant literature
concerning carbon dioxide–based tissue expansion in animal and human models.
The authors then analyze the similarities and differences between two
groundbreaking human trials (i.e., Patient Activated Controlled Expansion and
AirXpanders Patient Activated Controlled Tissue Expander) with carbon
dioxide–based expanders and discuss the risks and benefits associated with this
new technology. Results: At their site, the authors have enrolled 34 patients
using 36 experimental devices in total, and have found significantly shorter
expansion and overall reconstruction times in the patient-controlled tissue
expander group. Conclusions: The authors believe that carbon dioxide–based
devices may play a significant role in the future of implant-based breast
reconstruction, and may be widely applicable to other areas of plastic surgery
that also involve tissue expansion.
