Reed D S, Plaster A L, Mehta A, Hill M D, Zanganeh T S, Soeken T A, DeMartelaere S L, Davies B W
Department of Ophthalmology, Brooke Army Medical Center, San Antonio, TX, USA.
Ann Burns Fire Disasters. 2020 Dec 31;33(4):323-328.
Thermal burns of the periorbital region offer a particular challenge to surgeons in terms of satisfactory operative reconstruction. Several approaches currently exist, including full-thickness skin grafting following scar excision. The authors present a novel technique for the reconstruction of periorbital thermal burns involving the anterior lamella of the eyelid with simultaneous full-thickness skin grafting and amniotic membrane grafting. A retrospective review of six patients with periorbital thermal burn injury involving the anterior lamella of the eyelid(s) who underwent operative reconstruction utilizing this technique was performed. The operative and post-surgical outcomes were evaluated. In total, sixteen graft sites were examined. All graft sites demonstrated appropriate coverage and healthy re-epithelialization over the previously necrotic and burned areas. No evidence of cicatricial changes or lagophthalmos was noted. The postoperative outcomes demonstrate excellent functionality and cosmesis. By providing acute reconstruction, the risk of ophthalmic damage and vision loss secondary to cicatricial eyelid changes may be avoided. Additionally, utilizing only a minimal amount of tissue for reconstruction preserves vital skin. This analysis demonstrates the viability of simultaneous full-thickness skin grafting and amniotic membrane grafting for the acute and sub-acute reconstruction of periorbital thermal burn injury.
眼眶周围区域的热烧伤给外科医生在进行令人满意的手术重建方面带来了特殊挑战。目前有几种方法,包括瘢痕切除后进行全厚皮片移植。作者提出了一种用于眼眶周围热烧伤重建的新技术,该技术涉及眼睑前层,同时进行全厚皮片移植和羊膜移植。对6例眼眶周围热烧伤累及眼睑前层并采用该技术进行手术重建的患者进行了回顾性研究。评估了手术及术后结果。总共检查了16个移植部位。所有移植部位在先前坏死和烧伤区域均显示出适当的覆盖和健康的再上皮化。未发现瘢痕形成或兔眼的证据。术后结果显示出极佳的功能和美容效果。通过提供急性重建,可以避免因瘢痕性眼睑改变继发的眼部损伤和视力丧失风险。此外,仅使用少量组织进行重建可保留重要皮肤。该分析证明了同时进行全厚皮片移植和羊膜移植用于眼眶周围热烧伤急性和亚急性重建的可行性。