Tissue Expanders 101

July 30, 2009/Ryan

Ok, I know I’m a little late with this post, but I want to give you an idea of how tissue expanders work. Ryan had surgery June 17 to place two 100 cc silicone crescent shaped bags into his chest. They sit over his rib cage and are expanded one or twice per week with 10 cc of saline solution thus making the skin grow (or expand) slowly over time. 

The idea is to make enough extra skin so the surgeons can put that extra skin over Ryan’s heart and omphalocele after the Glenn procedure scheduled for August 27. Here are some pictures on Ryan’s expanders. 
There are ports located down by Ryan’s diaper. They are round like a watch face, metal on the back with a soft spot in the center front. Here is the fellow sterilizing the port site. The line you see by the fellow’s finger is the scar from the tissue expander surgery. Typically the plastic surgeon would make the incision up in the chest area, but due to Ryan’s anatomy he inserted them from the bottom. 
You can see the round port secured between the fellow’s index and second finger. He is inserting a needle into the port. The port is connected to the expander bag by a plastic tube. 
The saline is pushed through the needle through the port into the tubing and up into the bag. Ryan cries with the injections, but the plastic surgeon assures me the expansions themselves don’t hurt. 
Here is a view of the expander. It is 60% full. Dr. B thinks we will have plenty of skin for the Glenn. 

After Ryan’s expansion appointments, we head down to the cardiology clinic to have his sats watched for an hour. The concern is that as the expanders are expanded they will put pressure on Ryan’s breathing mechanism. This hasn’t been seen in any other tissue expansion case, but tissue expanders haven’t been used in infants and Ryan doesn’t breathe like other people. Tuesday, Ryan’s ox sats took longer than normal to raise back up to normal making his cardiologist uncomfortable with his condition. She ordered an echo to make sure we were truly dealing with an expander issue and not a shunt or cor triatriatum issue. Everything appeared normal (normal for Ryan that is) so Ryan was admitted for observation. And, the rest is history. 

I couldn’t help but take this picture of Ryan watching his own echo. Priceless!

So that is how the tissue expanders work. If I missed something, ask the question in the comments section and I’ll answer them there. 
Leighann/12 Comments/0 Likes/Ryan
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Comments (12)

  • Misty Rice / July 30, 2009 / Reply

    No questions, just sweet prayers for my little buddy. I just want to pick him up, hold him and kiss him. Precious little thing. So innocent, has no clue. Im glad he is so strong and part of that is having a lot of love from mom and dad to make him thrive. Thanks for the pics.

  • Lynnette Kraft / July 30, 2009 / Reply

    Wow. Truly amazing. I wanted to let you know that I just prayed for your family.

  • Courtney / July 30, 2009 / Reply

    you are so good at explaining things! we are praying…as always…

  • K-tribe / July 30, 2009 / Reply

    This comment has been removed by the author.

  • K-tribe / July 30, 2009 / Reply

    I have seen the tissue expanders before but never on a small child or like you said an infant. I give you mad props girl! I have to say I really dont know how you do it. You are such an awesome Mommy. Hang in there We are lifting you all up in prayer..
    Kelly K

  • K-tribe / July 30, 2009 / Reply

    PS- Its really neat to see your map of who has been here! 🙂

  • Indiana gramma / July 30, 2009 / Reply

    Thanks for the education.
    Poor little guy! Going through so much. I’m sorry you’ve had to learn about tissue expanders and the Glenn procedure and all that goes with it. Praying.

  • johanna / July 30, 2009 / Reply

    We are always praying for baby ryan. Poor little guy is such a trooper. You are awesome with the way you deal with all of this. Love you all.

  • amy / July 30, 2009 / Reply

    wow, that is truly amazing. they are really bulking him up – i can’t believe the amount of fluid that i can see in that last picture. we are praying for ryan and the family.

  • Anonymous / July 30, 2009 / Reply

    still praying for little man! Lori Musacchio

  • Anonymous / July 31, 2009 / Reply

    Just finished reading. Sent a prayer up for you and the family. You are awesome! I don’t know how you staying on top of all of this. Just remember there are so many people lifting you up. Love you. Amanda Luhn

  • Jennifer / July 31, 2009 / Reply

    Ryan is my HERO!!!

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