Paediactric burns – staged expander based reconstruction

Dr OLIVER MILES1, Dr Daniel Keating2

1St Vincent’s Hospital Melbourne, Fitzroy North, Australia, 2Austin Hospital, Melbourne, Australia


Burns and the associated tissue scarring, pigment change and contracture present significant difficulties surrounding reconstruction.


Retrospective chart audit of all patients receiving tissue expansion at Royal Children’s Hospital over the last decade. Logistic regression and T-testing were used as tests of statistical significance.


25 children underwent tissue expansion; 10 males, 15 females. 12 patients received osmotic expanders, 13 injectable expanders. In total there were 22 osmotic and 19 injectable expanders. The head and neck was the most common region (22/25 patients) and post burns scarring was the most common indication (9/25). Injectable expanders were used for defects requiring greater tissue expansion (mean 260mL vs 48mL, p=0.001) and had a greater rate of expansion (2.5mL/day vs 0.6mL/day, p=0.001) compared t osmotic expanders. 4 patients experienced a complication for osmotic vs 3 for injectable expanders. There was no significant difference in complication development based on expander type or indication. 2 patients did not reach 2nd stage reconstruction, 1 from each group of expander reconstruction. 2nd stage reconstruction was not significantly impacted on by expander type, indication or rate of expansion.


Burns and burns sequelae are effectively managed by tissue expansion. Osmotic expanders are typically used for smaller defects. There is no difference in overall complication rate or achieving 2nd stage reconstruction for each expander type or indication.


Plastic Surgical Resident, SVHM Melbourne.


ANZBA is a not for profit organisation and the peak body for health professionals responsible for the care of the burn injured in Australia and New Zealand. ANZBA encourages higher standards of care through education, performance monitoring and research.

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