Arch Plast Surg.  2021 Jul;48(4):378-383. 10.5999/aps.2020.02467.

The role of rapid tissue expansion in separating xipho-omphalopagus conjoined twins in Vietnam

• Son TT
• Dung PTV
• Thuy TTH
• Kien VD
• Liem NT

• KMID: 2518473
• DOI: http://doi.org/10.5999/aps.2020.02467

Abstract

Conjoined twins are rare, and each set of conjoined twins has a unique conjoined anatomy. It is necessary to perform separation to increase the chance of patient survival. Tissue expansion is an advanced technique for providing sufficient soft tissue and skin for wound closure. We report the successful application of rapid tissue expansion in 10-month-old xipho-omphalopagus conjoined twins in Vietnam. A tissue expander was placed on the anterior body between the sternum and umbilicus with a baseline of 70 mL sterile saline (0.9% NaCl). The first injection into the tissue expander began on the 6th day after expander insertion, and injections continued every 2 days with approximately 30–70 mL per injection according to the expansion of the skin. The expander reached 335 mL after six injections and within 10 days. In order to prepare for surgical separation, expansion was completed on the 15th day after insertion. The expanded skin area was estimated to be 180 cm², which was sufficient to cover both patients’ skin deficiencies. The twins presented for surgical separation 6 days following the completion of tissue expansion. Both babies were discharged in good health 1 month after separation.

Keyword

Xipho-omphalopagus conjoined twins / Conjoined twins / Tissue expansion / Separation / Vietnam