A prefabricated free flap for eyelid reconstruction. J Reconstr Microsurg 1998 Oct;14(7):479-82; discussion 483-4
Date
11/18/1998Pubmed ID
9819094DOI
10.1055/s-2007-1000210Scopus ID
2-s2.0-0031753512 (requires institutional sign-in at Scopus site) 7 CitationsAbstract
Patients with severe soft-tissue trauma to the ipsilateral upper and lower eyelid and surrounding structures represent a reconstructive challenge. The authors present a new approach to eyelid reconstruction, by creating a prefabricated free flap from the contralateral lower eyelid. New Zealand white rabbits were anesthetized, and the central artery and vein of the ear were mobilized and placed in a subcutaneous tunnel in the lower eyelid. After a delay procedure, flaps were made that measured 50 percent of the lower lid area. In an initial group (n = 9), the flaps were harvested at 3 weeks, and injected with Microfil, to demonstrate visual and radiologic patency and perfusion from the neopedicle. In a subsequent group of animals (n = 6), full-thickness defects of 50 percent of the left upper lid were created. Prefabricated free flaps from the right lower lid were transferred, anastomosing to the central artery and vein on the side of the eyelid being reconstructed. Tissue removed from the upper eyelid was placed in the defect of the lower lid donor site to serve as a control. Flaps were followed for periods of up to 6 months, documenting results photographically and by injection. Prefabricated free flaps from the lower eyelid maintained long-term patency and full-thickness perfusion from the pedicle, and also maintained size, shape, and accessory skin appendages better than composite graft controls. The authors concluded that prefabricated free flaps may be used to reconstruct eyelid defects; a surgical technique for application to human subjects is proposed.
Author List
Molnar JA, Yan JG, Matloub HSAuthor
Hani S. Matloub MD Professor in the Plastic Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AnimalsEar, External
Eyelids
Humans
Rabbits
Surgical Flaps