{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:23:30Z","timestamp":1788863010859,"version":"build-2803163510"},"reference-count":98,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2022,12,11]],"date-time":"2022-12-11T00:00:00Z","timestamp":1670716800000},"content-version":"vor","delay-in-days":344,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81930057"],"award-info":[{"award-number":["81930057"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81772076"],"award-info":[{"award-number":["81772076"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81971836"],"award-info":[{"award-number":["81971836"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"CAMS Innovation Fund for Medical Sciences","award":["2019-I2M-5-076"],"award-info":[{"award-number":["2019-I2M-5-076"]}]},{"name":"234 Academic Climbing Programme of Changhai Hospital and the Achievements Supportive Fund"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Currently, various external tissue expansion devices are becoming widely used. Considering the scarcity of relevant application standards, this systematic review was performed to explore the effectiveness and safety of external tissue expansion techniques for the reconstruction of soft tissue defects.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Method<\/jats:title>\n                  <jats:p>A systematic review and meta-analysis on the efficacy and safety of external tissue expansion technique was conducted. A comprehensive search was performed in the following electronic databases: PubMed\/Medline, Embase, Cochrane Library (Wiley Online Library), and Web of Science. Studies reporting patients with soft tissue defects under the treatment of external tissue expansion technique were included.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 66 studies with 22 different types of external tissue expansion devices met the inclusion criteria. We performed a descriptive analysis of different kinds of devices. A single-arm meta-analysis was performed to evaluate the efficacy and safety of the external tissue expansion technique for different aetiologies. The pooled mean wound healing time among patients with defects after fasciotomy was 10.548\u00a0days [95% confidence interval (CI)\u2009=\u20095.796\u201315.299]. The pooled median wound healing times of patients with defects after excisional surgery, trauma, chronic ulcers and abdominal defects were 11.218\u00a0days (95% CI\u2009=\u20096.183-16.253), 11.561\u00a0days (95% CI\u2009=\u20097.062-16.060), 15.956\u00a0days (95% CI\u2009=\u200911.916-19.996) and 12.853 days (95% CI=9.444-16.227), respectively. The pooled wound healing rates of patients with defects after fasciotomy, excisional surgery, trauma, chronic ulcers and abdominal defects were 93.8% (95% CI=87.1-98.2%), 97.2% (95%CI=92.2-99.7%), 97.0% (95%CI=91.2-99.8%), 99.5% (95%CI=97.6-100%), and 96.8% (95%CI=79.2-100%), respectively. We performed a subgroup analysis in patients with diabetic ulcers and open abdominal wounds. The pooled median wound healing time of patients with diabetic ulcers was 11.730\u00a0days (95% CI\u2009=\u200910.334-13.125). The pooled median wound healing time of patients with open abdomen defects was 48.810\u00a0days (95% CI\u2009=\u200935.557\u201362.063) and the pooled successful healing rate was 68.8% (95% CI\u2009=\u200945.9-88.1%). A total of 1686 patients were included, 265 (15.7%) of whom experienced complications. The most common complication was dehiscence (n\u2009=\u200953, 3.14%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Our systematic review is the first to demonstrate the efficacy and safety of external tissue expansion in the management of soft tissue defects. However, we must interpret the meta-analysis results with caution considering the limitations of this review. Large-scale randomized controlled trials and long-term follow-up studies are still needed to confirm the effectiveness and evaluate the quality of healing.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/burnst\/tkac045","type":"journal-article","created":{"date-parts":[[2022,12,11]],"date-time":"2022-12-11T16:06:31Z","timestamp":1670774791000},"source":"Crossref","is-referenced-by-count":16,"title":["Efficacy and safety of external tissue expansion technique in the treatment of soft tissue defects: a systematic review and meta-analysis of outcomes and complication rates"],"prefix":"10.1093","volume":"10","author":[{"given":"Xirui","family":"Tong","sequence":"first","affiliation":[{"name":"Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University , 168 Changhai Road, Yangpu District, Shanghai, 200433 , China"},{"name":"Research Unit of key techniques for treatment of burns and combined burns and trauma injury, Chinese Academy of Medical Sciences , 168 Changhai Road, Yangpu District, Shanghai, 200433 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianyu","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University , 168 Changhai Road, Yangpu District, Shanghai, 200433 , China"},{"name":"Research Unit of key techniques for treatment of burns and combined burns and trauma injury, Chinese Academy of Medical Sciences , 168 Changhai Road, Yangpu District, Shanghai, 200433 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University , 168 Changhai Road, Yangpu District, Shanghai, 200433 , China"},{"name":"Research Unit of key techniques for treatment of burns and combined burns and trauma injury, Chinese Academy of Medical Sciences , 168 Changhai Road, Yangpu District, Shanghai, 200433 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siqiao","family":"Wang","sequence":"additional","affiliation":[{"name":"Tongji University School of Medicine, Tongji University , Shanghai, 200092 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Runzhi","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University , 168 Changhai Road, Yangpu District, Shanghai, 200433 , China"},{"name":"Research Unit of key techniques for treatment of burns and combined burns and trauma injury, Chinese Academy of Medical Sciences , 168 Changhai Road, Yangpu District, Shanghai, 200433 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianliang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Hospital of the 92426 Troops of the Chinese People\u2019s Liberation Army , Tsingtao, 266400 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University , 168 Changhai Road, Yangpu District, Shanghai, 200433 , China"},{"name":"Research Unit of key techniques for treatment of burns and combined burns and trauma injury, Chinese Academy of Medical Sciences , 168 Changhai Road, Yangpu District, Shanghai, 200433 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yushu","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University , 168 Changhai Road, Yangpu District, Shanghai, 200433 , China"},{"name":"Research Unit of key techniques for treatment of burns and combined burns and trauma injury, Chinese Academy of Medical Sciences , 168 Changhai Road, Yangpu District, Shanghai, 200433 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shichu","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University , 168 Changhai Road, Yangpu District, Shanghai, 200433 , China"},{"name":"Research Unit of key techniques for treatment of burns and combined burns and trauma injury, Chinese Academy of Medical Sciences , 168 Changhai Road, Yangpu District, Shanghai, 200433 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shizhao","family":"Ji","sequence":"additional","affiliation":[{"name":"Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University , 168 Changhai Road, Yangpu District, Shanghai, 200433 , China"},{"name":"Research Unit of key techniques for treatment of burns and combined burns and trauma injury, Chinese Academy of Medical Sciences , 168 Changhai Road, Yangpu District, Shanghai, 200433 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6512-7171","authenticated-orcid":false,"given":"Zhaofan","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Burn Surgery, the First Affiliated Hospital of Naval Medical University , 168 Changhai Road, Yangpu District, Shanghai, 200433 , China"},{"name":"Research Unit of key techniques for treatment of burns and combined burns and trauma injury, Chinese Academy of Medical Sciences , 168 Changhai Road, Yangpu District, Shanghai, 200433 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,12,11]]},"reference":[{"key":"2022121210185733500_ref1","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1080\/17434440.2018.1426457","article-title":"Tissue expanders with a focus on extremity reconstruction","volume":"15","author":"Arain","year":"2018","journal-title":"Expert Rev Med 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