Eyelid Reconstruction with Full Thickness Skin Grafts After Carcinoma Excision

Various techniques have been proposed for reconstruction of the eyelid anterior lamella after carcinoma excision: among these are the transposition of skin flaps, and full-thickness skin grafts or combination of these two.

To present our experience in eyelid reconstruction with full-thickness skin grafts and to assess the aesthetic and functional outcomes.

The present retrospective study included 39 patients (20 males, 19 females, mean age 71 yrs) with surgically excised eyelid carcinoma, followed by reconstruction using full-thickness skin grafts. The patients were treated between 2005 and 2014. Parameters recorded were patient demographics, histological classification of malignancy, tumor localization and size, postoperative defect size. In cases of large full-thickness lower lid defect Hughes tarsoconjunctival flap was used for reconstruction of posterior lamella. Full-thickness skin grafts donor sites included upper eyelid, preauricular area and inner brachial area. We appraised the grafts viability one week after surgery and the aesthetic results - 6 months after surgery by the graft colour and lid position.

In 95% of the cases the skin grafts were viable. The full-thickness skin graft (FTSG) failed in two patients because of subcutaneous haematoma. There were a few early postoperative complications including graft hypertrophy, graft contraction, and partial graft failure, which were managed without additional surgery. All 39 patients had normal postoperative lid function. All 39 had either good (14) or excellent (25) cosmetic results.

Our findings suggest that full-thickness skin graft is a good choice in periocular reconstructive surgery after carcinoma excision. The surgical technique is easy to perform producing proper functional and aesthetic results.