Rapid Intraoperative Tissue Expansion with Latex Glove after Large Nevus Excision for a Pediatric Patient: A Case Report

Conventional concept of tissue expansion includes expander insertion, expander removal with wound coverage and intermittent expander inflations. Tissue expansion has been used in the various reconstruction area but high complication rates had been reported in the pediatric population. It may attribute to the inexperience of the medical team, poor education, improper follow-up and low compliance. Rapid intra-operative tissue expansion is a modified concept which utilizes the immediate expandability of the skin. Expansion forces are applied solely in the operative field and for only a short period of time. Ample volume of expansion has been reported in literature. We present the case of a 31-month-old female child with a giant nevus on the left upper arm. The nevus was excised and closed using a simple fabricated tissue expander. Expansion forces were applied only 25 minutes (15 minutes and 10 minutes with 5 minutes of intermittent break time) and the tissue was extended enough for tension free closure. The wound healed well without the complications like hematoma, seroma, wound dehiscence or necrosis. Key Words: Tissue expansion; Intraoperative period; Reconstructive surgical procedures