• M J Auletta, S L Matarasso, R G Glogau, and T A Tromovitch.
• Division of Dermatology, Robert Wood Johnson Medical School, New Brunswick, New Jersey 08901.
• J Dermatol Surg Oncol. 1993 Dec 1; 19 (12): 1084-8.

BackgroundImmediate tissue expansion has been reported to expand skin sufficiently to permit primary closure of large facial defects up to 5 cm in diameter.ObjectiveWe wished to evaluate and compare skin hooks with foley catheters in producing tissue expansion.MethodsSeven patients with post-Mohs surgery defects measuring 3.0 to 5.5 cm in diameter and located on scalp, temple, or forehead skin were treated with immediate tissue expansion.ResultsImmediate tissue expansion provided a 16 to 36% increase in the tissue available for closure, over and above what was achieved by undermining alone. In each case, adequate stretching of skin was achieved to permit primary closure relatively easily, which was not possible with undermining alone. Skin hooks were found to be equivalent to foley catheters in their ability to produce tissue expansion. At the one year follow-up visit, some spreading of the scar was noted, ranging from 1 to 7 mm, which appears in part to be related to the degree to which the skin was expanded.ConclusionThese findings support the concept that immediate tissue expansion is a separate and distinct process from undermining, which provides additional tissue for reconstructive surgery.

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