AeroForm tissue expander facilitates breast reconstruction after mastectomy

The Henry Ford Institute Against Cancer is the first in Michigan to offer a needle-controlled, needle-free tissue expansion system to women undergoing bad reconstruction after mastectomy.

FDA approved AeroForm tissue expander eliminates the need for weekly saline injections at the physician's office, improves patient comfort and can reduce the expander-based infection rate. Instead, the system fills the temporary implants with small doses of carbon dioxide triggered by a "medical wand" that patients can control at their own pace and in the comfort of each.

Jessica Linders is a bad cancer patient Henry Ford who used AeroForm tissue expander. As Linders had a genetic mutation, known as BRCA2, she decided to undergo a double mastectomy after being diagnosed with invasive and aggressive lobular bad cancer that had metastasized to the lymph nodes of her armpit. Every year in the United States, she is one of more than 100,000 women who undergo surgery to remove one or two cancerous bads.

Like 42% of women, Linders opted for reconstructive surgery after a mastectomy – a process that often begins immediately at the time of bad removal.

In his case, a temporary stent was inserted under the thoracic muscle to stretch the skin and muscle for possible permanent implant placement.

Traditionally, to stretch tissues, patients had to go to the plastic surgeon's office for weekly saline injections. In the case of Linders, the AeroForm tissue expander entrusted him with control of his expansion process under the direction of his doctor. There was no injection, no big weekly bolus of fluid, minimal pain and fewer visits to the plastic surgeon's office.

In addition to anxiety related to the enlargement of a recent surgical site, painful cramps can occur when the chest tissue is dilated rapidly by saline injections.

"This can give the impression that a doctor gives 75 cc or more of saline during a visit to an office.And the sensitive area can remain painful and tense for 48 to 72 hours" said Dunya Atisha, MD, director of Breast Reconstruction and Microurgery at Henry Ford.

But if the patient controls the process, it's less painful, she says. The woman regulates the amount of air used and the number of days of use. Patients can heal a bit every day or take a break for a day or two.

When Dr. Atisha explained the operation of the new air expander technology and compared it to saline expander, Linders chose the air expander.

"It was a done deal – just knowing that I did not have to have another needle stuck in my chest helped me make the decision," Linders said.

The concept of using expansion devices that did not require injections into a tissue expander was generated by a plastic surgeon from Silicon Valley. Dr. Dan Jacob was worried about his cancer patients who needed needle injections to fill their saline diluents.

"This technology is revolutionizing the process of expansion," says Dr. Atisha. "The needle-free alternative is the first major change in the expansion of bad tissue in over 40 years.This new system is the future of our field.It offers patients comfort and convenience increased, as well as for women a sense of control they guide their recovery from bad cancer.

"In addition, it theoretically reduces the risk of infection because it is not necessary to inject a needle through the patient's chest skin to get to the expander. It minimizes the risk of infection because it is not necessary to inject a needle through the patient's chest skin to get to the expander. also the patient's need to be away from daily duties due to multiple appointments and the process of recovering weekly saline injections ".

Results from the XPAND clinical trial show that patients using the AeroForm device achieved tissue expansion in 21 days on average, compared to an average of 46 days for patients with saline expansion. In addition, women who used the AeroForm device progressed to bad implantation a month faster on average than the saline group.

However, the expansion varies depending on the size of the woman, the amount of volume needed and the comfort level of the patient. "Everyone's experience is different and the time it takes to reach their goal varies," says Dr. Atisha.

To gradually stretch the skin on the chest wall with the help of AeroForm tissue expander, the woman holds a wireless device near her chest and presses a button to activate the electronics in the interior of the temporary implant. From a reservoir in the implant, the compressed carbon dioxide is gradually released in small amounts into the stent. The process can be repeated three times a day.

"It was cool that I could wiggle a medical wand over my bad and control the airflow while I was growing," said Linders, a 41-year-old resident of Fenton and a transition specialist for college students. specialized education. "It's a bit like you're blowing up a balloon, you can see the expansion and feel a little atmospheric pressure."

"I'm 98% satisfied," she says. The only drawback was that a small amount of air was released each day, but it was not a significant reduction.

The released carbon dioxide is not harmful. Carbon dioxide is actually a byproduct of what we exhale with each breath, says Dr. Atisha.

Linders used the AeroForm AirXpanders to stretch the skin on his chest for four weeks and then the process of expansion was complete.

After a thoracic expansion, the average patient will keep the extension implants in place for 2 to 3 months, Dr. Atisha explains. However, patients requiring chemotherapy and radiation therapy will retain the implants for 9 to 12 months.

"I would recommend this device to anyone undergoing bad reconstruction," Linders said.