Experimental Investigation And Clinical Application Of Expanded Capsule Angioarchitecture

In 1957, the first clinical application of implanted tissue expansion was reported by Neumann, who used the term "expansion of skin" at the same time. Radovan was the first plastic surgeon to use tissue expansion technique in clinical practice and gained successful experience in 1970's. His design of a silicone elastomer envelope with a remote self-sealing injection port became also the first standard device of skin expander. Undoubtedly, a new era came into reality after introduction of a silicone expander in reconstructive procedures. Although this method has been well known and successfully used in clinics for 30 years, the available data on the field are still limited and inconclusive. Most of the literatures are completed in experimental animals and only a few articles aimed directly at human body.According to statistic result, human epidermis was clearly thicker after than before expansion. Previous works have confirmed a significant increase in epidermal mitotic activity just after injection operation. When the expander beneath expanded skin is deflated, the mitotic index decreases to a subnormal level. The evidences from several surveys showed that the dermis or panniculus carnosus after expansion was significantly thinner contrast with the epidermis. Dermal thinning after expansion was observed equally in both children and adults. After expansion, the papillary dermis, especially for the reticular dermis, were filled with thick bundles of collagen fibers that were mostly oriented parallel to the surface of the skin. Active fibroblasts with large cisternae of rough endoplasmic reticulum were observed more frequently in expanded skin compared to normal skin. Skin appendages such as sebaceous, sweat glands and hair follicles, did not show any histologic change during the expansion process. The hair follicle is moved apart by large scalp extensions. Capillaries in the papillary dermis and the small blood vessels in the deep corium were dilated and filled with...