Tse D T, McCafferty L R
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Florida 33101.
Ophthalmology. 1993 Feb;100(2):260-8. doi: 10.1016/s0161-6420(93)31661-1.
Soft tissue expansion is a technique useful in reconstruction when a shortage of tissue exists. This method allows the creation of skin similar in appearance and type to that immediately adjacent to the defect. The use of this technique as a stage in repairing large periocular defects is presented. The sequence of implant placement, expansion, and ensuing eyelid reconstruction is illustrated.
The soft tissue adjacent to an eyelid defect was expanded by means of a subcutaneously implanted reservoir that was progressively inflated over several weeks by percutaneous injection of fluid. The prosthesis was removed after adequate expansion had been achieved. The expanded tissue was then used to fashion a local flap to resurface the defect.
Upper eyelid skin expansion was performed in one patient, and five patients received expansion in an adjacent area. The expanded tissue was then used to reconstruct the eyelid defect. The only complications encountered were tissue necrosis at the tip of an advancement flap in one patient and hematoma formation within the dissection pocket after expander insertion in another patient.
This technique complements existing reconstructive methods and provides a valuable surgical alternative for managing various periocular defects. The potential application of this technique in eyelid and periocular reconstruction appears promising.
当存在组织短缺时，软组织扩张是一种在重建中有用的技术。该方法能够创建外观和类型与缺损紧邻区域相似的皮肤。本文介绍了该技术作为修复大的眼周缺损的一个阶段的应用。阐述了植入物放置、扩张以及随后的眼睑重建的顺序。
通过皮下植入的贮液器对紧邻眼睑缺损的软组织进行扩张，在数周内通过经皮注射液体使其逐渐膨胀。在达到充分扩张后取出假体。然后使用扩张后的组织制作局部皮瓣来覆盖缺损。
1例患者进行了上睑皮肤扩张，5例患者在相邻区域进行了扩张。然后使用扩张后的组织重建眼睑缺损。仅遇到的并发症为1例患者推进皮瓣尖端的组织坏死以及另1例患者在植入扩张器后解剖腔隙内形成血肿。
该技术补充了现有的重建方法，为处理各种眼周缺损提供了一种有价值的手术选择。该技术在眼睑和眼周重建中的潜在应用前景似乎良好。
