Factors Influencing the Survival of Full-Thickness Skin Grafts in the Periocular Region
Author: Ahsen Hussain
Base Hospital / Institution: NOSM University, Thunder Bay, Ontario, Canada
ePoster presentation
Abstract ID: 25-385
Purpose
We sought to evaluate factors that influence the survival of full-thickness skin grafts (FTSG) in the periocular region.
Methods
Systematic review following PRISMA guidelines. We included English language original data studies involving at least one case of FTSG in the periocular region, in subjects over the age of 18, with data on graft survival. We excluded commentaries, animal studies, opinion pieces, case reports, any non-full-thickness grafts, and previously failed grafts.
Results
Our literature search found 18350 articles, of which 26 studies were included after screening. The average sample size was 64 (SD of 103), average participant age was 65.9 (SD of 13.4).
Based on 14 studies, FTSGs alone had a near 100% graft survival rate. Partial failure mostly was associated with the medial canthus and graft hypertrophy. Rescue of grafts via debridement led to survival. Based on 4 studies, FTSGs with tie-over dressings had a near 100% graft survival rate, with failures being associated with subcutaneous hematomas. Cyanoacrylate or fibrin glue did not have deleterious effects on graft survival in 2 studies. One randomized control study showed statistically significant loss of grafts in those given epinephrine with their local anaesthetic (p < 0.05). FTSGs with quilted sutures or amniotic membranes were shown to have high survival rates.
Conclusion
The vascularity of the periocular region allows for high survivability of FTSGs without additional supports. Bolster dressings, glue, quilted sutures, or amniotic membrane grafts may provide benefit. There may be poorer outcomes associated with local anaesthetics containing epinephrine.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Neetin | Prabhu | Department of Ophthalmology & Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada |
| Kevin | Hodgson | Department of Ophthalmology & Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada |
| Oyeleye | Oyesode | Department of Ophthalmology & Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada |
| Clara | Long | Department of Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada |
| Miso | Gostimir | Wills Eye Hospital, Philadelphia, Pennsylvania, USA |
| Arjav | Gupta | Department of Ophthalmology & Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada |
