Verhoekx Jennifer S N, Soebhag Renoe K, Weijtens Olga, van den Bosch Willem A, Paridaens Dion
The Rotterdam Eye Hospital, Rotterdam, The Netherlands.
Acta Ophthalmol. 2016 May;94(3):257-60. doi: 10.1111/aos.12927. Epub 2015 Dec 15.
To compare a simplified, single-layered closure technique with a double-layered closure technique in lower eyelid reconstruction following full-thickness pentagonal block excision.
We conducted a retrospective, non-randomized, interventional case-control study. Clinical data of consecutive patients treated with primary closure of a full-thickness lower eyelid defect between 2011 and 2014 were analysed. In group A, the defect was closed in one layer, using non-absorbable polypropylene sutures. In group B, the defect was closed in two layers, using absorbable polyglactin acid sutures. In both techniques, we rarely used a grey line suture to adjust the eyelid margin. We assessed notching, wound dehiscence and other complications, as reported at 2 months after surgery.
We included 188 eyelids from 186 patients. In group A, we included 82 eyelids and in group B 106 eyelids. We noted no difference in notching (p = 0.96) whilst wound dehiscence had not occurred in either group. Subcutaneous granuloma formation had been noted in 0 cases in group A, versus 4 in group B (p = 0.08). Mild redness of the scar was seen in 2 cases in group A, versus 5 in group B (p = 0.41). A grey line suture was placed in 6 cases in group A (7.3%), versus 4 cases in group B (3.8%; p = 0.28).
Both single- and double-layered closure techniques are safe and effective methods for primary closure of full-thickness lower eyelid defects. In both techniques, a grey line suture was rarely required to adjust the eyelid margin.
比较在全层五边形块状切除术后下睑重建中简化的单层缝合技术与双层缝合技术。
我们进行了一项回顾性、非随机、干预性病例对照研究。分析了2011年至2014年间接受全层下睑缺损一期缝合治疗的连续患者的临床资料。A组采用不可吸收聚丙烯缝线单层缝合缺损；B组采用可吸收聚乙醇酸缝线双层缝合缺损。两种技术中，我们很少使用灰线缝合来调整睑缘。我们评估了术后2个月报告的切迹、伤口裂开及其他并发症。
我们纳入了186例患者的188只眼睑。A组纳入82只眼睑，B组纳入106只眼睑。我们注意到两组在切迹方面无差异（p = 0.96），且两组均未发生伤口裂开。A组皮下肉芽肿形成0例，B组4例（p = 0.08）。A组2例出现瘢痕轻度发红，B组5例（p = 0.41）。A组6例（7.3%）放置了灰线缝合，B组4例（3.8%；p = 0.28）。
单层和双层缝合技术都是全层下睑缺损一期缝合的安全有效方法。两种技术中，很少需要灰线缝合来调整睑缘。
