Comparison of the survival rate of the upper lid skin pedicle flaps and the free skin grafts for lower lid anterior lamellar defect reconstruction
Author: Gregor Hawlina
Base Hospital / Institution: Eye Hospital, University Medical Centre Ljubljana, Slovenia
ePoster presentation
Abstract ID: 24-509
Purpose
When reconstructing larger lower lid anterior lamellar defect, surgeons often have to choose between an upper lid skin pedicle flap or a free skin graft. According to the “reconstruction ladder”, priority is given to the flaps. However, we are often in a dilemma if the defect is not suitably medially or laterally located whether the use of a flap should be prioritized.The aim of our retrospective study was to analyze the survival rates of upper lid skin pedicle flaps and free skin grafts used for reconstruction of large lower eyelid anterior lamella defects.
Methods
Patient data from 2017 to 2024 were collected. All procedures were performed by one surgeon at the Eye Hospital, University Medical Centre Ljubljana, Slovenia.The study included 79 cases from 75 patients with preopertive in postoperative documentation and photographs reviewed. Patients were divided into two groups: 26 patients (4 bilateral) with upper lid skin pedicle flaps and 49 patients with a free skin grafts. Survival rates were classified as full survival, partial survival, and total necrosis.
Results
In the first group (26 patients) full flap survival was observed in 22 cases (73.3%), partial survival in 5 cases (16.7%), and total necrosis in 3 cases (10%). In the second group (49 patients), full graft survival was registered in 37 cases (75.5%), partial in 0 cases, and total necrosis in 12 (24.5%).One case of graft necrosis required revisional surgical procedure due to cicatrization ectropion. Even in cases with total necrosis of flap or graft, defects were closed by secondary intention healing.
Conclusion
Our results show comparable survival rates of upper lid skin pedicle flaps and free skin grafts used for reconstruction of large lower eyelid anterior lamella defects. Successful outcomes were achieved with both methods. The results indicate that it is not essential whether to use a flap or a graft. The choice of technique may be influenced by the position of the defect, etiology, patient-specific factors, comorbidities and the surgeon’s expertise.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Janez | Bregar | Eye Hospital, University Medical Centre Ljubljana, Slovenia |
| Martin | Možina | Eye Hospital, University Medical Centre Ljubljana, Slovenia |
