Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
Index Copernicus  – 168.52
MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2019, vol. 28, nr 4, April, p. 535–539

doi: 10.17219/acem/90770

Publication type: original article

Language: English

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Observations on surgical reconstructive management following the excision of malignant neoplasms of the eyelid and periocular area

Robert Brodowski1,A,B,C,D, Paweł Pakla1,B,C, Mateusz Dymek1,B, Joanna Wojnar1,E, Wojciech Stopyra1,B, Piotr Haberko1,B, Jan Frańczak1,B,C, Michał Leja1,B, Bogumił Lewandowski1,2,E,F

1 Department of Maxillofacial Surgery, Frederic Chopin Clinical Hospital No. 1 in Rzeszów, Poland

2 Department of Emergency Medicine, Faculty of Medicine, University of Rzeszów, Poland

Abstract

Background. The surgical treatment of malignant neoplasms of the eyelid and the periocular area, due to the complex structure of the eye protective apparatus, remains a difficult surgical problem. The aim is to reconstruct the missing tissue as precisely as possible, both from a functional and esthetic point of view. Postoperative disorders of eyelid function may considerably disturb both the functioning and the quality of life of the patients.
Objectives. The aim of the study was to evaluate 262 patients who had underwent operations related to malignant neoplasms of the eyelid and the periocular area, and to demonstrate which reconstruction methods for post-resection defects were the most advantageous in terms of functions and esthetics.
Material and Methods. The study was based on an analysis of the medical records of 262 patients. The analysis included the reconstruction techniques used, the patient’s age, the sizes and locations of the primary skin cancer, any healing complications, and the distant esthetic and functional outcomes.
Results. Various types of flap procedures were the most frequently used techniques in the studied group of patients (66.8%). Single flaps were used in 83 patients, multiple flaps in 89 patients and complex flaps with a cartilage graft in 3 patients. Free skin grafts were used in 52 patients and were associated with complications in the form of partial necrosis. Complications during postoperative wound healing were observed in 18.3% of the patients. In 12 patients, the complications were associated with a local infection, in 15 patients with partial, marginal necrosis and in 8 patients partial wound breakdown after the transfer of the flap occurred.
Conclusion. The most frequently used mechanisms for correction and reconstruction of the deficits following the excision of the eyelid skin and periorbital malignancies included various flaps used in a total of 175 patients (66.8%).

Key words

flap, wound healing, periorbital neoplasm

References (13)

  1. Özkaya Mutlu Ö, Egemen O, Dilber A, Çelebioğlu S. Esthetic unit-based reconstruction of periorbital defects. J Craniofac Surg. 2016;27(2):429–432.
  2. Cook BE Jr, Bartley GB. Treatment options and future prospects for the management of eyelid malignancies: An evidence-based update. Ophthalmology. 2001;108(11):2088–2098.
  3. Rathore DS, Chickadasarahilli S, Crossman R, Mehta P, Ahluwalia HS. Full thickness skin grafts in periocular reconstructions: Long-term outcomes. Ophthal Plast Reconstr Surg. 2014;30(6):517–520.
  4. Tirone L, Schonauer F, Sposato G, Molea G. Reconstruction of lower eyelid and periorbital district: An orbicularis oculi myocutaneous flap. J Plast Reconstr Aesthet Surg. 2009;62(11):1384–1388.
  5. Jelks GW, Jelks EB. Prevention of ectropion in reconstruction official defects. Clon Plast Surg. 2001;28(2):297–302.
  6. Papadopoulou C, Solbach MC, Lorenz B, Luciani F. Treatment options for basal cell carcinomas of the medial canthus [in German]. Klin Monbl Augenheilkd. 2016;233(1):38–43.
  7. Fang S, Yang C, Zhang Y, et al. The use of composite flaps in the management of large full-thickness defects of the lower eyelid. Medicine (Baltimore). 2016;95(2):e2505.
  8. Jelks GW, Jelks EB. Prevention of ectropion in reconstruction of facial defects. Clon Plast Surg. 2001;28(2):297–302.
  9. Zlatarova ZI, Nenkova BN, Softova EB. Eyelid reconstruction with full thickness skin grafts after carcinoma excision. Folia Med (Plovdiv). 2016;58(1):42–47.
  10. Shi Y, Zhou X, Yu J, Liu H. Reconstruction of full-thickness eyelid defects following malignant tumor excision: The retroauricular flap and palatal mucosal graft. J Craniofac Surg. 2016;27(3):612–614.
  11. Meissner M, Hofmann W, Kaufmann R. Reconstruction of the upper eyelid: Full-thickness skin grafting between the same contralateral esthetic units. J Dtsch Dermatol Ges. 2016;14(3):319–320.
  12. Hishmi AM, Koch KR, Matthaei M, Bölke E, Cursiefen C, Heindl LM. Modified Hughes procedure for reconstruction of large full-thickness lower eyelid defects following tumor resection. Eur J Med Res. 2016;21(1):27.
  13. Bertrand B, Colson TR Jr, Baptista C, et al. Total upper and lower eyelid reconstruction: A rare procedure. A report of two cases. Plast Reconstr Surg. 2015;136(4):855–859.
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