Background. Tissue expansion is a well-established surgical technique that produces an additional amount of normal skin to cover\na defect. This technique is appealing because the skin quality and color are from the patient�s own. The widely used injectable\nexpanders are of great reliability but carry the disadvantage of being painful during injection and most of the time require multiple\nclinic visits. So the idea of self-inflation became attractive and hydrogel expanders were developed and became widely known for\nbeing painless during clinic visit and decrease number of visits.Thefirst generation expandersweremodified by adding an enclosing\nplastic shell to decrease the unopposed expansion that occurred in the first generation expanders, which lead to pressure necrosis\nof the skin flaps. This made it an attractive option for tissue expansion in children and some adult patients. Patients,Materials, and\nMethods. Charts of 17 patients were retrospectively reviewed, all of them had second generation self-inflating expanders implanted\nover a 2-year period for one of two purposes, the treatment of giant nevi or burn scars. Results. Fifteen patients were females and\n2 were males. The indication was large burn scar in 14 cases (14/17), in which 47/55 expanders were implanted, and giant nevus in\n3/17 cases in which 8/55 expanders were implanted. Extrusion of the expander occurred in 8/55 expanders (14.5%), which occurred\nin 6/14 patients. The highest percentage of extrusion occurred in the neck in which two out of three expanders extruded; otherwise\nthis complication does not seem to be related to the indication, gender, nor age of the patients. It seems to be that it is technical in\nnature.The patients did not have to get any injections to fill the tissue expanders, which made the expansion process less painful\nand more convenient. Conclusion.This seems to be currently the largest published review in which second generation expanders\nwere used. Those expanders seem to offer a desirable advantage of being painless for children, also they do not require repeated\nvisits to the surgeon�s clinic, which is of great value for patients living in the periphery.
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