Clinical Application Of Skin Soft-tissue Expansion And A Systematic Review And Meta-analysis:Risk Factors For Infection Of Tissue Expansion

Background:Skin soft-tissue expansion,using tissue expanders to expand skin and soft-tissue and create“extra" tissue to reconstruct skin soft-tissue defects,experienced more than 4 decades of development,combined with prefabricated flap technique,perforator flap technique,imaging technology,stem cell transplant technique,now can be used to build lager expanded flap,has become a routine technique for reconstruction and repair in plastic surgery,allowing us to repair larger and larger defected regions.But skin soft-tissue expansion technique has its deficiency:The treatment cycle is long and the expense is high and the incidence of complications related to skin soft-tissue expansion is high.Common complications are such as infection,hematoma,incision dehiscence,cutaneous necrosis,and so on.The poor prognosis caused by complications hinder its further development and application,especially the infection complication has great impact on the success of the whole treatment.Hitherto,there is no meta-analysis of risk factors concerning skin expansion infection.Objective:This study aims to conduct meta-analysis,with the merging data to amplify the sample size to verify the risk factors related to tissue expanders infection and finally provide reference data and the primary prevention information for front-line clinicians.Thus,as far as possible to reduce the incidence of complications and improve treatment effects.Data and methods:By researching through Pubmed,Cochrane Library,Embase,Wanfang Med Online and CNKI,we arranged literatures published during 1986-2016.We conducted literature selection,according to the standards of inclusion and exclusion.Results:Finally,we adopted 19 retrospective observational studies published during 1986-2016 for meta-analysis about risk factors for infection of tissue expander,according to the data in these studies.8280 patients are included.Expanders' location(extremities),adjacent cicatrice,out-set of injection valves,smoking habits,diabetes and radiation therapy,these risk factors' OR(odds ratio)95 percent confidence interval are larger than 1,having statistical significance,implying there is an significant correlation between these risk factors and infection of expanders.Conclusion:Risk factors like location(extremities),adjacent cicatrice,out-set of injection valves,smoking habits,diabetes and radiation therapy,may possibly increase the incidence of infection of skin soft-tissue expanders.This meta-analysis provides evidence that infection of tissue expanders is associated with specific risk factors,such as location,adjacent cicatrice,out-set of injection valves,smoking habits,diabetes and radiation therapy...