TOC Eye and Face, Austin, Texas.
Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Ophthalmic Plast Reconstr Surg. 2021;37(3S):S66-S69. doi: 10.1097/IOP.0000000000001816.
There have been limited studies evaluating specifically the incidence of wound dehiscence following isolated upper blepharoplasty. This is a large-scale upper blepharoplasty review to evaluate the rate of wound dehiscence, to assess risk factors, and to analyze management outcomes.
A retrospective review was performed of all patients who underwent upper blepharoplasty at a single surgery center. All incisions were closed using either 6-0 fast-absorbing plain gut or polypropylene suture in a running fashion, with an additional interrupted suture near the lateral wound edge. Incidence of wound dehiscence was determined and further assessed by patient age (≤67 or >67 years), gender, preexisting medical conditions, smoking history, and suture type.
A total of 1,190 patients (2,376 eyelids) met inclusion criteria. In total, there were 34 instances (1.4%) of wound dehiscence in 32 patients at an average 9 days (range, 0-30 days) following surgery. Evaluation of wound dehiscence rates by demographic factors revealed male gender to be a significant predictor of wound dehiscence (p = 0.0062). Age, hypertension, heart disease, and diabetes were not predictors of wound dehiscence. Lifetime smoking history increased risk for wound dehiscence (p < 0.0001). Use of fast-absorbing plain gut suture was also significantly associated with dehiscence, when compared with polypropylene (p = 0.0025). Multivariate analysis revealed male gender and fast-absorbing plain gut suture to be independent risk factors for wound dehiscence. Seventeen eyelids with wound separation were observed for second-intention healing, 1 underwent delayed scar revision. Fourteen eyelids were repaired primarily using suture and 3 with cyanoacrylate surgical skin adhesive. All patients reported satisfaction with their final outcome, and objective final healing was deemed satisfactory.
Wound dehiscence following isolated upper blepharoplasty is rare and associated with male gender and fast-absorbing plain gut suture. Patients with wound separation may be successfully managed with individualized care.
仅有少数研究专门评估了单纯上睑成形术后伤口裂开的发生率。本研究为一项大规模的上睑成形术回顾性研究，旨在评估伤口裂开的发生率，评估危险因素，并分析处理结果。
对在一个手术中心进行的所有上睑成形术患者进行回顾性研究。所有切口均采用 6-0 速吸收普通肠线或聚丙烯缝线连续缝合，外侧切口边缘附近加间断缝线。根据患者年龄（≤67 岁或＞67 岁）、性别、既往内科疾病、吸烟史和缝线类型确定伤口裂开的发生率，并进一步评估。
共纳入 1190 例患者（2376 只眼）。术后平均 9 天（0-30 天）时，32 例患者的 34 只眼（1.4%）发生伤口裂开。根据人口统计学因素评估伤口裂开率，发现男性是伤口裂开的显著预测因素（p = 0.0062）。年龄、高血压、心脏病和糖尿病不是伤口裂开的预测因素。终生吸烟史增加了伤口裂开的风险（p＜0.0001）。与聚丙烯缝线相比，速吸收普通肠线缝合与伤口裂开显著相关（p = 0.0025）。多因素分析显示，男性和速吸收普通肠线缝合是伤口裂开的独立危险因素。17 只眼出现伤口分离，二期愈合；1 只眼行延迟性瘢痕修复。14 只眼采用缝线修复，3 只眼采用氰基丙烯酸酯外科皮肤粘合剂修复。所有患者对最终结果均满意，客观最终愈合情况满意。
单纯上睑成形术后伤口裂开罕见，与男性和速吸收普通肠线缝合有关。伤口分离的患者可通过个体化治疗成功处理。
