4.2\ Tissue Expander

4.2.1\ Discussion

Tissue expanders are used to stretch the skin for later use in various reconstructive procedures, such as to correct burn alopecia. These devices are essentially fluid-filled silicone sacs, connected to an infusion port. The conventional expander requires serial filling over a period of several months. Osmotic self-filling expanders are also available. On CT, the

a

expander appears as a fluid-filled sac within the scalp (Fig. 4.2). A radial fold may project into the lumen of the expander. These can attain relatively large sizes. Identification of an infusion port helps distinguish the device from an abscess. Many of the infusion ports have magnetic components that are not MRI compatible. Complications related to tissue expanders include extrusion and rupture. The presence of a radial fold is a normal feature of certain tissue expanders and should not be mistaken for rupture.

b

Fig. 4.2  Scalp tissue expander. The patient has a history of severe burns to the face. Sagittal CT image (a) shows a saline-filled skin expander device within the scalp, poste-

rior to the craniectomy defect. Photograph of an unfilled expander (b) (Courtesy of Melissa Guilbeau)