Upper Blepharoplasty and Lateral Wound Dehiscence

Area of Science:

• Ophthalmology
• Plastic Surgery
• Wound Healing

Background:

• Lateral wound dehiscence (LWD) is a potential complication following upper blepharoplasty (UB).
• Understanding the frequency and prevention of LWD is crucial for improving surgical outcomes.

Purpose of the Study:

• To determine the incidence of LWD after UB.
• To evaluate a novel technique for preventing LWD by addressing lateral wound tension.

Main Methods:

• Retrospective review of LWD cases (2003-2009) followed by a prospective comparative study (2009-2013).
• Subjects were divided into two groups: Group 1 received buried orbicularis/subcutaneous sutures before skin closure, while Group 2 had skin closure only.
• Exclusion criteria included re-operation, skin healing disorders, and incomplete follow-up.

Main Results:

• The initial audit identified an LWD rate of 2% (14/678 cases).
• In the prospective study, the LWD rate significantly decreased to 0.3% (1/293) in Group 1 (with buried sutures) compared to Group 2.
• Group 1 patients were significantly younger (mean age 41.4 years) than Group 2 (mean age 56.1 years).

Conclusions:

• Intraoperative assessment of wound tension is key for identifying patients at risk for LWD.
• Tension-relieving buried sutures (6-0 polyglactin) in the lateral UB incision effectively prevent LWD.
• This technique offers a reliable method to reduce the incidence of lateral wound dehiscence in upper blepharoplasty.