Semicircular Flap Repair of Full-Thickness Eyelid Defects Using Only Anterior Lamella

摘要

? Purpose: ?Current rotational flap techniques for closure of large full-thickness eyelid defects often call for the use of a posterior lamellar free graft in addition to the anterior lamellar rotational flap. We describe a technique to repair large full-thickness eyelid defects using only the anterior lamellae of the semicircular flap. ? Methods: ?We performed a retrospective review of a consecutive case series and reviewed the charts of all patients undergoing semicircular flap repair for closure of a full thickness eyelid defect at the Cole Eye Institute between March 2000 and April 2009. Charts were reviewed for size and location of the defect, surgical procedure for defect closure, complications, and follow-up interval. ? Results: ?Forty-nine eyelids of 49 patients (44 lower and 5 upper) underwent full thickness eyelid defect reconstruction using only a semicircular rotational flap with no posterior lamellar graft. The posterior lamella was allowed to granulate in each case. All defects occurred after excision of an eyelid cutaneous malignancy (46 after Moh’s micrographic surgery and 3 after margin-controlled excision at the time of repair). The average defect size measured 17 mm (range, 11 to 27 mm). Average follow-up interval was 10 months (range, 1 to 74 months). Complications included 4 patients with pyogenic granuloma (8.2%), 3 patients with trichiasis requiring epilation (6.1%), and one patient with cicatricial ectropion (2%), which required surgical correction. No other patients requested or required additional surgical intervention. ? Conclusions: ?Semicircular rotational flap reconstruction of full-thickness eyelid defect using only the anterior lamellae with no posterior lamellar graft allows for straightforward repair, maintenance of structure and function, and few post-operative complications. ? Keywords: eyelid ? wound healing ? oncology?.