Topic: ESOPRS 2021 ePoster sessions
Time: Sep 17, 2021 16:00 Amsterdam, Berlin, Rome, Stockholm, Vienna, 15:00 London
(plain text version here)
Split thickness skin graft alongside dermis fat grafting as a single site graft in the context of complex eyelid pathology: a case series
Author: Meriam Islam
ePoster Number: 252,00
Purpose
To report the outcomes of patients undergoing dermis fat grafting (DFG) and the use of the overlying skin as a split thickness skin graft (STSG) during eyelid surgery. In the context of complex eyelid pathology with multiple pre-existing surgical procedures, lagophthalmos presents a challenge. We present our “waste not want not” approach, reporting the outcomes of patients undergoing DFG and the use of the overlying skin as a STSG in patients with lagophthalmos.
Methods
Retrospective consecutive case series of all patients to date who underwent DFG alongside STSG simultaneously at a single centre, Queen Victoria Hospital, East Grinstead, United Kingdom. We describe the clinical background, indications, surgical technique, complications and outcomes for this cohort of patients.
Results
9 dermis fat and 8 split thickness skin grafts were performed on 7 patients (mean age 47.6 years range 10-82 years). Indications included lagophthalmos in all patients with a compromised cornea +/- sulcus hollowing, secondary to conditions including Steven Johnson syndrome, facial nerve palsy, congenital eyelid defects and buphthalmos secondary to congenital glaucoma. 4 patients had a DFG and STSG to the same eyelid, and 3 had a DFG and STSG to different eyelids. 2 patients had additional isolated DFG to another ipsilateral eyelid. All patients had an objective improvement in their lagophthalmos post-operatively with minimal contraction to the graft site at early follow up. Outcome measures including patient comfort improved in all 6 patients that have thus far attended follow up. Those with epithelial defects (ED) all resolved, with 4/5 patients with an ED fully resolving and not recurring. 1/5 cases included 1 corneal melt with a resolved infection which continued requiring further corneal intervention.
Conclusion
This study provides proof-of-concept that eyelid dermis fat grafting alongside overlying split thickness skin grafting can both be used concurrently, either on the same or different eyelid for reconstruction or improving lagophthalmos.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Anthony | Yao | Queen Victoria Hospital |
| Raman | Malhotra | Queen Victoria Hospital |
Abstract ID: 25-309
