Liu Haiying, Wang Kun, Wang Qigang, Sun Shudong, Ji Youxin
Qingdao Central Hospital, Qingdao, Shandong Province 266042, PR China.
J Med Case Rep. 2011 Aug 15;5:373. doi: 10.1186/1752-1947-5-373.
Contractures, ectropion and scarring, the most common sequelae of skin grafts after eyelid burn injuries, can result in corneal exposure, corneal ulceration and even blindness. Split-thickness or full-thickness skin grafts are commonly used for the treatment of acute eyelid burns. Plasma exudation and infection are common early complications of eyelid burns, which decrease the success rate of grafts.
We present the cases of eight patients, two Chinese women and six Chinese men. The first Chinese woman was 36 years old, with 70% body surface area second or third degree flame burn injuries involving her eyelids on both sides. The other Chinese woman was 28 years old, with sulfuric acid burns on her face and third degree burn on her eyelids. The six Chinese men were aged 21, 31, 38, 42, 44, and 55 years, respectively. The 38-year-old patient was transferred from the ER with 80% body surface area second or third degree flame burn injuries and third degree burn injuries to his eyelids. The other five men were all patients with flame burn injuries, with 7% to 10% body surface area third degree burns and eyelids involved. All patients were treated with a modified surgical procedure consisting of separation and loosening of the musculus orbicularis oculi between tarsal plate and septum orbital, followed by grafting a large full-thickness skin graft in three days after burn injury. The use of our modified surgical procedure resulted in 100% successful eyelid grafting on first attempt, and all our patients were in good condition at six-month follow-up.
This new surgical technique is highly successful in treating eyelid burn injuries, especially flame burn injuries of the eyelid.
挛缩、睑外翻和瘢痕形成是眼睑烧伤后皮肤移植最常见的后遗症，可导致角膜暴露、角膜溃疡甚至失明。中厚皮片或全厚皮片常用于治疗急性眼睑烧伤。血浆渗出和感染是眼睑烧伤常见的早期并发症，会降低移植成功率。
我们报告8例患者的病例，其中2例中国女性和6例中国男性。第一位中国女性36岁，全身70%体表面积为二度或三度火焰烧伤，双侧眼睑均受累。另一位中国女性28岁，面部被硫酸烧伤，眼睑为三度烧伤。6例中国男性年龄分别为21岁、31岁、38岁、42岁、44岁和55岁。38岁的患者从急诊室转来，全身80%体表面积为二度或三度火焰烧伤，眼睑为三度烧伤。其他5名男性均为火焰烧伤患者，体表面积3%至10%为三度烧伤，眼睑受累。所有患者均采用改良手术治疗，包括在睑板和眶隔之间分离并松解眼轮匝肌，然后在烧伤后三天移植大片全厚皮片。采用我们的改良手术方法首次眼睑移植成功率达100%，所有患者在六个月随访时情况良好。
这种新的手术技术在治疗眼睑烧伤，尤其是眼睑火焰烧伤方面非常成功。
