Skin grafts may be used for coverage of facial defects in situations in which alternative methods of reconstruction,such as local flaps,are not an option.They may also be beneficial for patients who wish to avoid or w...Skin grafts may be used for coverage of facial defects in situations in which alternative methods of reconstruction,such as local flaps,are not an option.They may also be beneficial for patients who wish to avoid or who are not good candidates for more complex reconstruction.Full-thickness skin grafts often have a better color and texture match to adjacent skin when compared to split-thickness grafts;however,split-thickness grafts have lower metabolic demand and increased survival rate.Composite grafts may be very useful in the repair of defects with unique contour and support requirements,such as the nasal ala and eyelid.With all grafts,thoughtful planning and sound surgical technique are critical in achieving the best possible functional and aesthetic result.展开更多
· AIM: To reconstruct the extensive full-thickness defects of eyelids is a challenge for the plastic surgeon because of their complex anatomy and special functions.This article presents and discusses an improved ...· AIM: To reconstruct the extensive full-thickness defects of eyelids is a challenge for the plastic surgeon because of their complex anatomy and special functions.This article presents and discusses an improved surgical technique in which the orbicularis oculi myocutaneous flap is rotated through a "subcutaneous tunnel" in conjunction with a palatal mucosal graft employed for lining.·METHODS: Data from 22 eyes with extensive full-thickness eyelid defects from various causes between2009 and 2013 were analyzed in this study. After the different layers of eyelid were separated completely, a temporally based orbicularis oculi myocutaneous flap was designed following fishtail lines and was mobilized,leaving the base of the pedicle intact with a submuscular tissue attachment. The flap was then rotated through a "subcutaneous tunnel" to the defect, and the donor site was closed primarily. Posterior lamellar reconstruction was performed with a mucosal graft harvested from the hard palate.·RESULTS: All the flaps were survived without any healing problems. There was no corneal irritation, flap contraction, or significant donor-site morbidity in the follow-up period. The incision scars were almost invisible.The defects were repaired completely, and the evaluations showed satisfactory function and appearance.·CONCLUSION: This technique is an improved singlestage operation and can be applied to repair large, full-thickness eyelid defects from various causes. With our method, the functional and aesthetic results can be obtained in either the upper or lower eyelids.展开更多
文摘Skin grafts may be used for coverage of facial defects in situations in which alternative methods of reconstruction,such as local flaps,are not an option.They may also be beneficial for patients who wish to avoid or who are not good candidates for more complex reconstruction.Full-thickness skin grafts often have a better color and texture match to adjacent skin when compared to split-thickness grafts;however,split-thickness grafts have lower metabolic demand and increased survival rate.Composite grafts may be very useful in the repair of defects with unique contour and support requirements,such as the nasal ala and eyelid.With all grafts,thoughtful planning and sound surgical technique are critical in achieving the best possible functional and aesthetic result.
基金Supported by Jilin Province Science and Techology Development Plan Project(No.20150414032GH)
文摘· AIM: To reconstruct the extensive full-thickness defects of eyelids is a challenge for the plastic surgeon because of their complex anatomy and special functions.This article presents and discusses an improved surgical technique in which the orbicularis oculi myocutaneous flap is rotated through a "subcutaneous tunnel" in conjunction with a palatal mucosal graft employed for lining.·METHODS: Data from 22 eyes with extensive full-thickness eyelid defects from various causes between2009 and 2013 were analyzed in this study. After the different layers of eyelid were separated completely, a temporally based orbicularis oculi myocutaneous flap was designed following fishtail lines and was mobilized,leaving the base of the pedicle intact with a submuscular tissue attachment. The flap was then rotated through a "subcutaneous tunnel" to the defect, and the donor site was closed primarily. Posterior lamellar reconstruction was performed with a mucosal graft harvested from the hard palate.·RESULTS: All the flaps were survived without any healing problems. There was no corneal irritation, flap contraction, or significant donor-site morbidity in the follow-up period. The incision scars were almost invisible.The defects were repaired completely, and the evaluations showed satisfactory function and appearance.·CONCLUSION: This technique is an improved singlestage operation and can be applied to repair large, full-thickness eyelid defects from various causes. With our method, the functional and aesthetic results can be obtained in either the upper or lower eyelids.
