The use of tissue expansion in lower extremity wounds in paraplegic patients.

A report of the use of tissue expansion in the lower extremity of paraplegic patients is presented with over 1-year follow-up in two cases. Expansion was accomplished without difficulty and without compromise of skin integrity when performed carefully and slowly. It is important to observe the overlying skin for capillary refill. Pain, which may limit expansion in neurologically intact patients, is not a factor in paraplegics. By using tissue expansion, more risky, longer procedures using myocutaneous flaps or microvascular tissue transfers may be unnecessary, and reliable, durable, full-thickness coverage is obtained in two short procedures.