Reconstruction of periorbital region defects: A retrospective study

Abstract

Background:Although the periorbital region forms less than 1% of the total body surface, it has a very complex anatomy; therefore, it requires a detailed approach. In this work, we aim to present the clinical applications and related literature for the algorithm of the technique which will be applied, according to the location of the defect, in choosing the surgery treatment method. Factors affecting the results and different treatment methods of the anatomical region, including its difficult reconstruction, will also be included.Materials and Methods:A review of 177 periorbital region defect reconstructions was performed.Results:As a treatment method, in 76 (43%) patients primary closure was chosen, 39 (22%) patients had grafts and in 62 (35%) patients a flap was chosen as a treatment alternative. With respect to postoperative complications, there were a total of 6 (3.38%) patients observed with venous congestion. In 11 (6.21%) patients ectropion developed, in 1 (0.56%) patient minimal space between the eyelids while monitoring recovery was observed and in 1 (0.56%) patient, flap loss was observed due to a circulatory disorder.Conclusions:The aim of reconstruction is to repair the defect suitable to normal physiological and anatomical values. As a result, before the surgical treatments in this difficult anatomical region, the defect width and anatomical localization must be evaluated. The most suitable reconstruction method must be identified, using an evaluation of the algorithm and the required functional and esthetical results can be obtained with intraoperative flexible behavior and a change of method, when necessary.

Porcine Urinary Bladder Extracellular Matrix for Treatment of Periocular Skin Defects

“…Primary anterior lamella defects were located at the lower eyelid (12), upper eyelid (4), medial canthus (2), lateral canthus (1), and postexenterated socket (1), while those situated elsewhere on the face included the brow (1) and preauricular donor site (4). Defects were secondary to Mohs resection (11 sites), necrotizing fasciitis (5), donor site or surgical wounds (4), trauma (2), skin graft breakdown (1), chalazion removal complicated by loss of anterior lamella (1), and epidermolysis bullosa (1). Wound characteristics for all sites included in this study are summarized in the Table . Following the conclusion of treatment, all wounds successfully epithelialized (Fig.…”

“…L arge periocular anterior lamella defects have traditionally been reconstructed with myocutaneous advancement flaps and full-or partial-thickness skin grafts (FTSG). [1][2][3][4][5][6][7] More recently, medical devices such as allograft and xenograft skin substitutes comprising biologic extracellular matrix have presented minimally invasive treatment alternatives. There exist numerous options on the market, including AlloDerm (Allergan, Dublin, Ireland), Integra (Integra LifeSciences, Plainsboro Township, NJ, U.S.A.), MatriStem (ACell, Columbia, MD, U.S.A.), and Enduragen (Tissue Science Laboratories, Aldershot, United Kingdom).…”

The Prevalence and Treatment Costs of Non-Melanoma Skin Cancer in Cluj-Napoca Maxillofacial Center

“…However, 19% of head and neck cancers are located on the skin [ 25 ]. Particularly, the orbital region had the highest cost of treatment per episode, which may be due to the difficulty of local reconstruction of this anatomical area [ 28 , 29 ]. These results are different from other research, where nasal and auricle NMSC had the highest treatment costs [ 5 , 16 , 19 ].…”

Periorbital Trauma: A New Classification

“…Some authors used “periocular region” and “periorbital region” as interchangeable terms. Either region was described as the area including the upper eyelids, lower eyelids, and canthal regions 12345678…”