Laissez-Faire: How Far Can You Go?

Abstract

This report shows the technique of healing by laissez-faire can be extended for relatively large defects with good results. The medial canthal region and full-thickness lower lid defects remain the favored locations for healing by secondary intention. In large defects particularly with extension onto the cheek, there is a significant risk of cicatrization, and the possibility of a second corrective operation should be discussed with the patient prior to tumor excision.

Anterior lamellar excision and laissez-faire healing for aberrant lashes in ocular cicatricial pemphigoid

“…This was decreased to 4 mm high strip in both upper and lower lids to reduce risk of lid retraction, hypertrophic scar, or even an entropion secondary to reduced anterior lamellar support. Laissez fairer healing in periocular region has been used for increasingly larger defects with satisfactory cosmetic and functional outcomes along with low rates of infection and wound contraction; 8 and this was confirmed with our results. Absence of lashes was more obvious for upper lids than lower lids and if the procedure was unilateral due to asymmetry.…”

A prospective case series of secondary intention healing for surgical wounds on the dorsum of the hand

“…Secondary intention healing has always been nature's way of dealing with wound repair. Zitelli 2 and several papers have reported its use for wounds in the medial canthus and the lower eyelid, [3][4][5][6][7][8][9] and for other sites on the head and neck. [10][11][12][13][14][15][16] These studies consistently highlight the value of this simple management option, with low rates of wound infection and good cosmetic and functional outcomes.…”

Secondary intention healing in skin surgery: our own experience and expanded indications in hidradenitis suppurativa, rhinophyma and non‐melanoma skin cancers

“…4 found that the best functional and cosmetic results were obtained at locations with concave geometry, when the defect lies symmetrically at the junction of the anatomical subunits. The typical established areas where SIH is recommended are as follows: temporal and medial‐orbital (canthal) areas, lower eyelids and naso‐labial (medial cheek) area 15 . Lowry et al.…”

“…The functional and cosmetic results were satisfactory in approximately three‐quarters of the patients, and only two patients required secondary repair. The use of SIH in other facial locations, that is, forehead, central and lower cheeks, mandibular margin and chin, brings inferior results 5,15 …”