Injection solution dyeing for verification of needle position in tissue expansion

Background When inflating multiple tissue expanders in an outpatient basis, correct location of the expander port can be sometimes perplexing, even for experienced personnel. Herein, we review a series of patients whose expanders were dyed with soluble dye added to the injected solution as a further means of verification of needle position during serial expansions. Methods Thirty patients with a total of 81 expanders were followed. The expanders were filled with methylene blue dyed solution in the initial operative procedure. Data regarding patient demographics, surgery etiology, number and location of implanted expanders, and postoperative complications were collected for analysis. Results At total of 80 (98.7 %) expansions were completed successfully with subsequent reconstructions. Three patients required treatment for surgical site infections, one patient had a wound dehiscence, and one patient required drainage of a postoperative hematoma. One expander was removed due to extrusion. None of the patients had complications related to expander rupture or puncture. None were noted to have side effects related to methylene blue exposure. During subsequent outpatient expander inflations, medical staffs reported a higher confidence in port location thus simplifying the inflation procedure. Conclusions Although many surgeons currently use methylene blue dyeing technique to facilitate tissue expansion, there are no reports to attest to the safety of this method. The short series presented herein serves to further outline the safe application of this technique to tissue expansion. Level of Evidence: Level IV, risk/prognostic study.