Tissue expansion for improvement of the perforator flap donor site

As perforator flaps have become more routine, their selection today must not only meet the recipient site requirements, but also insure minimal disruption of the donor site itself. If a skin graft to close that donor site has or will be used, this detriment can perhaps be circumvented by using traditional tissue expansion techniques. This can be initiated pre-transfer, at the time of flap transfer, or in the post-transfer period. Readily available, easy to use, and most versatile are rectangular shaped expanders. The number of expanders used per case depends on the size of the donor defect. The duration of the expansion process can be lengthy and is usually measured in months. At least two surgical procedures are required. Therefore, this alternative for improving the perforator flap donor site requires a highly motivated and compliant patient.