ePoster listing and sessions

Topic: ESOPRS 2021 ePoster sessions
Time: Sep 17, 2021 16:00 Amsterdam, Berlin, Rome, Stockholm, Vienna, 15:00 London

 

 

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Use of penile full thickness skin grafts in complex eyelid burns reconstructions to avoid sight threatening corneal exposure

Author: Adriana Chilinska
ePoster Number: 192


Purpose

To present the surgical techniques and outcomes in using autologous foreskin and penile shaft full thickness skin graft in the management of complex severe facial burns with sight threatening corneal exposure.


Methods

We present series of 4 patients of severe bilateral burns to upper and lower eyelids in men aged 21-50 years, treated in a regional burns unit between 2013-2018 in close cooperation between Oculoplastic and Plastic Surgery burns teams. Three due to thermal burns, one due to a chemical burn with acid.Full thickness donor site foreskin and penile shaft skin was harvested by plastic surgeon. The oculoplastic surgeon performed full tarsorraphy. The graft was placed onto the debrided upper and lower lid defects as a composite, and secured using a fibrin sealant.All of our patients sustained full thickness burns involving facial area with 25-80 % of total body surface burn. 1 patient sustained severe chemical burns to corneas which required one eye to be enucleated prior to lid reconstruction.


Results

Good graft take was achieved in all patients. Full cornea protection was provided in all cases with good eyelid position and function maintained once the tarsorraphies were divided in all 4 cases.


Conclusion

The common donor sites for full thickness skin grafts can be unavailable in severe extensive burns. Skin grafting to each lid separately often results in contracture and cicatrix of the graft resulting in recurrent corneal exposure.Penile skin is an ideal material for eyelids due to high content of elastic fibres and a low content of smooth muscle fibre making it less likely to contract as compared to any other donor sites. Prepuce skin is hairless, plentiful and easy to harvest; with shaft skin requiring secondary split skin coverage. The main disadvantage is its hyperpigmentation which can cause poor colour match.Combining this choice of donor site with prolonged extensive permanent tarsorraphy we have been able to preserve the eyelid conformation and avoid early complications of contracture and recurrent exposure.


Additional Authors

First nameLast nameBase Hospital / Institution
LyudmilaKishikovaEye Department Royal Victoria Infirmary Newcastle upon Tyne
SanjayVarmaPlastic Surgery Department Royal Victoria Infirmary Newcastle upon Tyne
LucyClarkeEye Department Royal Victoria Infirmary Newcastle upon Tyne

Abstract ID: 20-122