2. When should routine expansion generally begin following tissue-expander insertion?
A. Immediately after surgery
B. Within 24–48 hours
C. After adequate wound healing, generally around 2 weeks
D. Only after 6 weeks
Answer:
C. After adequate wound healing, generally around 2 weeks.
After insertion of a tissue expander, expansion is not usually started immediately. The incision and surrounding tissues need sufficient time to heal before repeated mechanical stress is applied through inflation.
The review you shared describes beginning expansion once the incision has healed sufficiently, generally about 2 weeks after expander placement. Wagh & Dixit — Tissue expansion: Concepts, techniques and unfavourable results
Why wait?
Early postoperative tissues are still undergoing inflammation and wound healing. Premature expansion can place excessive tension on the fresh incision and potentially contribute to wound dehiscence, ischemia, infection or expander exposure.
Once healing is satisfactory, serial expansion can begin. At each session, saline is added until the tissue reaches an appropriate degree of tension. Pain and especially blanching of the overlying skin are warning signs against further inflation.
Why the other options are incorrect
A. Immediately after surgery — Although some intraoperative filling may be performed depending on the situation, this is different from commencing routine postoperative expansion.
B. Within 24–48 hours — The incision has not developed adequate healing strength for routine serial expansion.
D. Only after 6 weeks — Generally unnecessarily long in an uncomplicated wound and substantially delays the expansion process.
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