97th DOG Annual Meeting 1999
P635
THE RECONSTRUCTION OF LARGE FULL-THICKNESS DEFECTS OF THE LOWER EYELID WITH FREE AUTOGENOUS TARSOCONJUNCTIVAL GRAFTS
A. Nestler, I. Sterker
Background: After tumor resection full-thickness defects of the lower eyelid with substantial tissue loss are often too large for a primary wound closure. Depending on size and location of the defect an adequate method of reconstruction is to be chosen. A free tarsoconjunctival graft can be used alternatively to the established tarsoconjunctival transposition by Hughes (and modifications).
Patients: We report two cases in which large full-thickness defects of the lower lid following basal cell carcinoma resection were repaired using a free tarsoconjunctival graft to replace the posterior lamella. The graft was obtained by excision of the ipsilateral upper lid. To reconstruct the anterior lamella we used a skin-muscle flap: in one patient as an advancement flap from the lower lid (procedure described by Beyer-Bathrick) in the other patient as a laterally based advancement flap covering the secondary skin defect with a free skin graft (procedure described by Leone and Hand).
Results: Good functional and cosmetical results were achieved. There were no instances of infarction or rejection of any part of the transplanted tissues. In one patient a granuloma developed at the conjunctival excision site at the upper lid and was excised subsequently.
Conclusion: Good functional and cosmetic results can be achieved using free tarsoconjunctival grafts combined with a skin-muscle flap in reconstruction of large lower lid defects.
Dept. Ophthalmology, Univ. Leipzig, Liebigstr.10-14, D-04103 Leipzig
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