The Authors relate their experience in repairing losses of skin in the limbs with tissue expansion. Of the 73 patients treated, 31 had a lesion of the upper limbs and 42 of the lower limbs. Such lesions were: 32 burn scars, 19 traumatic scars, 15 congenital nevi, 1 radiation scar, 2 lymphatic malformations and 4 vascular malformation. Eight patients. underwent re-expansion. The surgical technique is somewhat different from that used in other parts of the body. This is due to the different elasticity and blood supply of the skin of the limbs and to the cylindrical shape of the limbs themselves which, especially in the distal parts, means that there are no flat areas big enough to be expanded. Thus expansion has to be slower and more careful than in other parts of the body and involves the use of multiple small hyperinflated expanders. The capsule around the prosthesis usually needs removing to obtain more skin, its adhesion to the receiving site and less post-operatory retraction. Excellent results were obtained in 57 cases. 8 cases will need re-expansion as the original lesion was quite large. Major complications included 3 infections, 1 haematoma and 4 exposures of the expanders. No major complications were reported in the case of re-expansion.
