Complications of Skin Expansion in the Pediatric Population: A 10-year Retrospective Study

Objectives: This study aimed to discuss the risks and complications associated with skin expansion in the pediatric population, a common plastic surgery technique. Methods: Fifty-one patients who underwent skin expansion between 2013 and 2022 at the Plastic Surgery and Burns Unit of the Children's Hospital in Rabat were included in this retrospective study. This study aimed to report all results, analyze them, and compare them with existing literature to determine predictive elements of complications in the pediatric population. Results: The study used 96 expanders of three different brands in 70 procedures. Only one expander was often used, but up to seven expanders were used in some cases. Expansion sessions began after an average of 15 days of expander placement, with an average total expansion rate of 105.5%. Complications were encountered in 16 of 96 expanders (16.6%), with infection being the most serious complication, found in four cases. Other complications included skin complications, expander malfunctions, skin necrosis, loose sutures, exposure of the valve, and hair loss with stretch marks. The use of multiple expanders was the only statistically relevant factor toward complications. Conclusions: The study concluded that skin expansion is not without risks and reported complication rate range from 9.6% to 30% in the pediatric population. Multicenter studies specific to each variable will allow better identification of the risk factors and standardization of the indications. The study provides valuable insights into the risks and complications associated with skin expansion in the pediatric population, which could help guide medical professionals in making informed decisions when considering this procedure.