Prevention of ectropion when using expanded skin flap to repair periorbital soft tissue defect
10.3760/cma.j.cn114453-20200428-00255
- VernacularTitle:扩张皮瓣修复眶周软组织缺损睑外翻的预防方法
- Author:
Xiangyue WANG
1
;
Qianwen WANG
;
Jiaqi WANG
Author Information
1. 中国医学科学院北京协和医学院整形外科医院面颈部整形美容一中心 100144
- Keywords:
Tissue expansion;
Surgical flaps;
Ectropion;
Periorbital soft tissue defect
- From:
Chinese Journal of Plastic Surgery
2021;37(1):84-87
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the method and effect of preventing eyelid ectropion when using expanded skin flap to repair periorbital soft tissue defect.Methods:From April 2015 to December 2019, 176 patients with periorbital soft-tissue defect were treated in the Plastic Surgery Hospital of Chinese Academy of Medical Sciences, including 79 males and 97 females, aged 4-53 years, the defect ranging from 1 cm×1 cm-6 cm×10 cm. According to the location and size of the defect, an appropriate expander was selected before the operation. In the first stage, the expander was embedded, and saline was injected regularly. In the second stage, the expanded flap was transferred to cover the periorbital defect wound, part of the capsule was removed, and the flap was fixed on the periosteum to restore the position and shape of the eyelid and prevent eyelid ectropion. After the operation, elastic headgear was worn for 3-6 months for shaping. The survival and complications of the flaps were followed up.Results:The expander volume was 30-400 ml, and the expansion time was 1-6 months. The size of the expanded flap was 3 cm×3 cm-6 cm×9 cm. All flaps survived after 2 months to 4 years follow-up. Among them, 13 cases had mild lagophthalmus, which was caused by insufficient skin expansion and did not affect the eyelid function, so the patients refused to retreat; 8 cases of lower eyelid ectropion, including 5 cases of scar contracture, 1 case of suture knot falling off, and 2 cases of lower eyelid support tissue relaxation caused by long-term stretching of expander, 5 cases were corrected after skin flap repair, 3 cases were not treated again; the rest were satisfactory. The depression left by the suture fixing flap disappears within 1 to 6 months after surgery.Conclusions:When using an expanded skin flap to repair periorbital soft-tissue defect, preoperative, intraoperative and postoperative interventions were implemented to reduce or disperse the retracting force of expanded skin flap, which could avoid eyelid ectropion and achieve good repair effect.
