Skinflate: A More Comfortable Way to Expand Pediatric Tissues

Some pediatric patients have lesions (moles, birthmarks, tumors), burns, or scars that are too expansive for excision and primary closure. Pediatric craniofacial surgeons may treat these complex defects with tissue expansion, a two-step intervention that allows for the best aesthetic outcome. In the first operation, a silicone tissue expander is placed underneath nearby non-affected skin and tissue. For the next three to four months, saline is injected weekly into the internal port, which directs fluid to enter and gradually expand the expander. Healthcare providers administer these injections in the clinic. Sometimes, the patient’s parents may administer the injections at home, if they receive the proper post-operative education. Injections are terminated when the expander reaches a specified volume (150-600 cc). In the second operation, the diseased anatomy is excised, and the expanded non-affected skin and tissue is rotated or recruited to cover the area of excision.

All pediatric-approved tissue expanders rely on transcutaneous saline injections to expand. The required weekly injections are often painful, scary, and uncomfortable for pediatric patients. Moreover, a majority of patients must come to the clinic to receive their injections, and this is particularly inconvenient for families who live far away from the clinic, or parents who are unable to frequently request time off from work. With a completely internalized tissue expander, we intend to create a solution that eliminates transcutaneous injections, and requires fewer patient visits to the clinic. We hope to make tissue expansion safer and more comfortable for the children who need it.