Comment on 'minimising the risk of ectropion when full thickness skin grafting lower eyelids' Lau et al J Plast Reconstr Aesthet Surg 2008;61:1562-4.

摘要

Lau et al aver that Figure 3.7 of the tenth edition of 'Fundamental Techniques of Plastic Surgery' makes "no allowance... for the concave surface and the lack of tension in the lower eyelid skin while a template was made of the excisional defect"1. They err. The third part of the illustrated sequence shows the use of a template to mark the outline of the intended graft on the back of the ear. Part of the template is obscured by the operator's finger but the margins of the template outline can be extrapolated easily to the point at which they meet. The second drawing in the sequence shows the length of the upper 'straight' template margin to be 23 mm and the distance from its midpoint to the midpoint of the lower 'curved' margin to be 6 mm. The third illustration in the series shows the same measurements to be 23 mm and 9 mm respectively. The text which accompanies the illustrations in the book (p. 41) is equally revealing. 'When the pattern can only be made once the defect is surgically created, the defect should be displayed to the full before making the pattern. This applies with particular force when the defect is on the eyelid, when failure to make the pattern and consequently the graft of a size to fill the defect in full results in residual ectropion.