Lille S T, Engrav L H, Caps M T, Orcutt J C, Mann R
Department of Surgery, University of Washington Burn Center, University of Washington, Seattle, USA.
Plast Reconstr Surg. 1999 Sep;104(3):637-45. doi: 10.1097/00006534-199909030-00004.
Split-thickness skin grafts are commonly used for the treatment of acute eyelid burns; in fact, this is dogma for the upper lid. Ectropion, corneal exposure, and repeated grafting are common sequelae, almost the rule. It was hypothesized that for acute eyelid burns, the use of full-thickness skin grafts, which contract less than split-thickness skin grafts, would result in a lower incidence of ectropion with less corneal exposure and fewer recurrences. The records of all patients (n = 18) who underwent primary skin grafting of acutely burned eyelids (n = 50) between 1985 and 1995 were analyzed retrospectively. There were 10 patients who received full-thickness skin grafts (12 upper lids, 8 lower lids) and 8 patients who received split-thickness skin grafts (15 upper lids, 15 lower lids). Three of 10 patients (30 percent) who received full-thickness skin grafts and 7 of 8 patients (88 percent) who received split-thickness skin grafts developed ectropion and required reconstruction of the lids (p = 0.02). No articles were found substantiating the concept that only split-thickness grafts be used for acute eyelid burns. The treatment of acute eyelid burns with full-thickness rather than split-thickness skin grafts results in less ectropion and fewer reconstructive procedures. It should no longer be considered taboo and should be carried out whenever possible and appropriate.
中厚皮片常用于急性眼睑烧伤的治疗；事实上，这对上睑来说已是既定做法。睑外翻、角膜暴露和反复植皮是常见的后遗症，几乎成为规律。据推测，对于急性眼睑烧伤，使用收缩程度小于中厚皮片的全厚皮片，将降低睑外翻的发生率，减少角膜暴露并降低复发率。对1985年至1995年间接受急性烧伤眼睑初次植皮的所有患者（n = 18）的记录（n = 50）进行了回顾性分析。有10例患者接受了全厚皮片移植（上睑12例，下睑8例），8例患者接受了中厚皮片移植（上睑15例，下睑15例）。接受全厚皮片移植的10例患者中有3例（30%）发生睑外翻并需要眼睑重建，接受中厚皮片移植的8例患者中有7例（88%）出现睑外翻并需要眼睑重建（p = 0.02）。未发现有文章证实急性眼睑烧伤仅应使用中厚皮片这一概念。用全厚皮片而非中厚皮片治疗急性眼睑烧伤可减少睑外翻的发生并减少重建手术。不应再将其视为禁忌，应在可能且合适的情况下进行。
