1.My child has facial scarring due to burns, and I heard that it can be treated with skin dilation, can you give us a brief introduction to skin dilation? For patients with forearm scars after trauma, we decided to treat them with skin expansion surgery because the forearm scars are very wide and it is difficult to remove and close them directly. During the first surgery, we place a dilator on each side of the scar; the dilator used in plastic surgery today is a sac-like structure made of medical silicone rubber, which is one of the most central materials for soft tissue skin expansion. Roughly speaking, the commonly used dilators consist of three parts: the dilating capsule, the injection pot and the connecting catheter. Once the dilator is buried under the skin and the incision has healed securely, sterile saline is injected into the dilator through the dilator’s injection jug at regular intervals, usually every 5-7 days, until the dilator is filled with water; next, the second surgery is started to remove the scar from the forearm and use the expanded flap transfer to repair the wound left after scar removal. To summarize, skin expansion is a plastic surgery technique used to repair skin defects by simply burying a skin expander under the normal skin and injecting saline into the skin expander to make the skin on the expander expand continuously, providing “extra” normal skin. 2, skin dilation in plastic surgery can treat what diseases or deformities? Skin dilation is widely used in the field of plastic surgery, in our hospital, for example, the application of skin dilation are: (1) the treatment of various scars, skin dilation has become one of the most commonly used treatment methods for scalp scars or scarring baldness, scars on the face and neck, scars on the trunk, limbs have very good results. (2) Some common benign skin lesions, such as congenital nevus nigricans, hemangiomas, and neurofibromas, can also be treated with skin dilation. (3) Some important head and neck tissues or organs, such as external ear and nose defects can also be reconstructed by skin expansion. 3.My child has turned 3 years old this year, can skin dilation be performed? In our clinical work, pediatric patients account for a large proportion of skin expansion patients; compared to adults, the skin of pediatric patients is well suited for skin expansion surgery due to its excellent texture and elasticity. However, there is after all a certain amount of pain in any surgery, especially when skin dilator injection treatment is performed between 2 surgeries, the patient needs to be able to cooperate well with the doctor who injects the water; otherwise, it is easy to cause leakage of the dilator injection pot, and once this happens, the injection pot can only be replaced, or the dilator can be replaced directly, which not only increases the cost of treatment, but also prolongs the treatment time. According to my personal experience, generally speaking, after a child reaches 4 weeks of age, he or she can tolerate dilator injection treatment well enough to be considered for skin expansion surgery. Therefore, I suggest you wait for another year and come back to the hospital for surgical treatment after the child reaches 4 weeks of age. 4.My child is 5 weeks old and is ready for skin dilatation treatment, may I ask: Is this the best time for treatment? As mentioned above, skin expansion treatment can be performed after the child reaches 4 years old. Your child is already 5 years old, so it is perfectly fine, and, personally, I think it is the best time for treatment. Due to burns, scalds, chemical burns, etc., scars are formed on the child’s skin and should be treated before school age. 5 weeks old-6 1/2 years old is the prime age for treatment for two reasons: first, as the child gets older, self-awareness and psychological development gradually occurs, and if there are scars on the body, it will cause a great obstacle to the child’s healthy growth, and second, if the child ends the treatment before school age If we miss this golden age, it would be a pity that the child would need to take a break from school for future treatment. 5.After consideration, we are ready to use skin dilation for treatment, how long will the total treatment time be? This is a question that all patients are concerned about. Skin expansion surgery is different from general plastic and cosmetic surgery, and a prominent feature is that the treatment time is longer. Generally speaking, a complete skin expansion procedure consists of 2 surgeries and a water injection process in between. The first surgery is performed for the implantation of the expander, and generally about 2 weeks after the surgery, saline is injected into the expander, every 5-7 days, and the water injection process generally lasts about 3-5 months, and when the expander is finished, the second surgery is performed to excise the scar, remove the expander, and repair the scar left after excision with the additional normal skin from the expansion; from the above description A course of skin dilation takes at least oh 3-5 months. Although many scholars have tried the rapid dilation technique, it is less effective than the traditional dermal dilation technique. Therefore, the patient or the family of the child who is ready to undergo skin dilation should be well prepared in terms of time before starting the treatment. 6.Our child is 6 years old and has a 10cm x 10cm dark pigmented nevus on his back, can it be treated with skin dilation? Skin dilation is mainly used to treat skin scars from various causes, however, for some benign skin lesions such as nevus nigricans, hemangioma, neurofibroma, etc., treatment by applying skin dilation can also receive very good treatment results. Your child is already 6 years old, and the area of nevus nigricans is not particularly large, so it is completely possible to apply skin expansion surgery for treatment. 7. Although our daughter is already 6 years old, according to you, she can be treated by skin dilation, but our child is rather spoiled, and we are also worried that it must be very painful for our child to carry a dilator and grow such a big “bag”, right? From clinical experience, compared to adults, children seem to have a better ability to tolerate the expansion of the skin, when the dilator is filled with water, we use a very fine needle, the puncture of the skin is not very painful, after the dilator is filled with water, the skin will have some swelling, but this feeling will soon disappear, the child does not feel very uncomfortable, so please rest assured. Although the “bag” is big, but this “bag” is only temporary after all, in order to treat the scar, this “bag” is still acceptable. 8. We are usually busy at work and we have to earn money, so we would like to ask the elderly, such as the child’s grandfather, grandmother, or grandparents, to watch the child in Beijing during the water injection period, do you think it is possible? It is perfectly fine. After the dilator is buried, you can go home and continue your work during the water injection period. Our ward will fix 2 mornings every week for patients who come to the hospital for water injection treatment, you just need to ask the elderly to bring their children to the ward. 9. It is a little difficult for us to stay in Beijing for more than 4 months. Do you think it is okay for us to go back to local water injection after burying the dilator? If you can get water in Beijing, it is better to get water in Beijing, so it is safe. However, if your family is in a big city and you happen to know a plastic surgeon at the local hospital who also performs skin dilatation, then I think it is possible if you can get in touch with such a surgeon and if he is willing to inject water for you or your child. Other than that, it is not recommended to go home or back to the local area for water injection. 10.Our child has already had the dilator buried and started the water injection treatment, what should we pay attention to during this time? Generally speaking, there is nothing special to pay attention to, as long as you follow the doctor’s instructions and come to the hospital for regular visits and regular water injections. During the water injection period, you should pay attention to the cleanliness of your skin and please take a shower, but on the day of dilator injection, it is better not to take a shower to avoid dilator infection. In the late stage of dilator injection, some patients have red skin on the dilator, dilated capillaries and tortuous veins, which are normal. However, when you sit and sleep, you should mainly not press the skin on the dilator to avoid causing the skin on the dilator to break down and affect the effect of surgical treatment. One of the biggest principles is that once you encounter any problem, you must immediately contact the attending physician and return to the hospital in time to deal with it accordingly.