Department of Ophthalmology, National University Hospital, Singapore.
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Ophthalmic Plast Reconstr Surg. 2020 Jul/Aug;36(4):349-354. doi: 10.1097/IOP.0000000000001547.
To evaluate the surgical outcome and safety of acellular human dermal allograft as a new lining material to the exposed orbit after exenteration.
Retrospective case series of patients who underwent orbital exenteration followed by reconstruction with meshed-type acellular dermal allograft from 2009 to 2018 in a single tertiary institution.
There were 14 eyes (2 right, 12 left) of 14 patients (6 men, 8 women). Mean age at operation was 69.1 ± 16.5 years. Indication for surgery was malignancy in all patients. One patient underwent subtotal exenteration, while the rest underwent total exenteration. SureDerm Meshed was used in 12 patients, AlloDerm Meshed in 1, and CGDerm Meshed in 1. Mean follow-up period was 12.1 months. Full or nearly full epithelialization occurred in 10 of 14 patients (71.4%) at 1 month and 9 of 12 patients (75.0%) at 3 months. There was delayed epithelialization in 3 patients due to poor wound care (n = 1), adjuvant radiotherapy (n = 1), and adjuvant radiotherapy followed by cerebrospinal fluid leak (n = 1).
Meshed acellular human dermal allograft showed good success in reconstruction after orbital exenteration and may be considered as an alternative lining material to split-thickness skin graft after orbital exenteration.
评估脱细胞异体真皮作为眼眶内容剜除术后暴露性眼眶新衬里材料的手术效果和安全性。
回顾性分析 2009 年至 2018 年在一家三级医疗机构行眼眶内容剜除术联合网孔型脱细胞异体真皮重建的患者。
共纳入 14 例患者的 14 只眼（右眼 2 例，左眼 12 例）。患者的平均年龄为 69.1±16.5 岁。所有患者均因恶性肿瘤而行手术治疗。1 例患者行次全眶内容剜除术，其余 13 例患者行全眶内容剜除术。12 例患者使用了 SureDerm 网孔型脱细胞异体真皮，1 例患者使用了 AlloDerm 网孔型脱细胞异体真皮，1 例患者使用了 CGDerm 网孔型脱细胞异体真皮。患者的平均随访时间为 12.1 个月。14 例患者中有 10 例（71.4%）在术后 1 个月和 12 例患者中有 9 例（75.0%）在术后 3 个月实现了完全或近乎完全上皮化。3 例患者因伤口护理不佳（1 例）、辅助放疗（1 例）或辅助放疗后并发脑脊液漏（1 例）导致上皮化延迟。
网孔型脱细胞异体真皮在眼眶内容剜除术后重建中取得了良好的效果，可作为眼眶内容剜除术后替代断层皮片的衬里材料。
