Spontaneous reformation of lower eyelid.

Abstract

SUMMARY Eleven consecutive patients with tumours involving the lower eyelid margin were treated with margin-including full-thickness excision of the eyelid and suturing of bleeding vessels as the sole primary surgical procedure, needing less than 10 minutes. The resulting defects of 2/5 to 7/8 of the horizontal extent of the eyelid and varying in height from 4 to 7 mm were allowed to heal spontaneously. In all the 11 patients the wounds healed, without ocular or palpebral complications in about 6 weeks and underwent further cosmetic improvement for the ensuing 6-8 weeks. Cosmetic results were excellent in 8 patients with excisions of 2/5 to i of the eyelid. All procedures including the secondary reconstructions were carried out on day-case basis under local anaesthesia. Histology confirmed complete tumour clearance in all the patients. Apart from being the first report of a planned study of spontaneous repair of full-thickness surgical wounds of the lower eyelid this study shows that the conventional method of dressing such wounds can be replaced by the less expensive and convenient 'dressing' of a cartella shield with an improvised central hole.

Laissez-Faire: How Far Can You Go?

“…Our results are comparable to the series reported by Mehta (1981) in which only one patient required secondary surgery. However, Mehta did not describe any defects involving the upper lid or lateral canthus.…”

“…Our results are not unique, Fox and Beard (1964) described good results following healing by secondary intention in 6 medial canthal defects and Mehta (1981) reported 11 cases of satisfactory healing by secondary intention with defects involving the lower lid and medial canthus. Beare (2005) reported on a large series with excellent results.…”

Spontaneous repair of lower eyelid after tumour excision

“…Mehta (1981) achieved the best results in younger patients and for excisions involving the medial half of the lower eyelid. Apart from being very simple, the procedure also shows that open wounds in the eyelid heal in a few weeks.…”

“…This method has been described before by Mehta (1981). The required therapy has great cosmetic and functional consequences for the patient.…”

Minimally Invasive Options for Cutaneous Defects: Secondary Intention Healing, Partial Closure, and Skin Grafts

“…If the canthal defect extends onto either lid, or there is a paucity of redundant skin, guiding sutures can be used to prevent eyelid distortion caused by wound contraction. Defects involving the lower lid margin heal acceptably if less than 50% of the lid is involved, and the defect is full thickness [48,49]. Healing of defects on the nose and the ear depends on the subsite [41,50].…”