Underrated yet effective: Secondary intention healing of eyelid defects in elderly patients

Eyelid reconstruction following tumor excision poses both functional and aesthetic challenges. Although complex surgical techniques are frequently employed, secondary intention healing remains a less commonly used option in periorbital surgery. This case series aimed to assess the functional and aesthetic outcomes in patients with eyelid defects treated with the laissez-faire approach.

A retrospective analysis was conducted of six patients with post-excisional eyelid defects who underwent secondary intention healing at the Department of Dermatology, Klinikum Ludwigshafen, between 2016 and 2024. Healing time, complications, functional and aesthetic outcomes were assessed after at least 6 weeks or 6 months postoperatively.

The average patient age was 77 years. The indication for surgery was basal cell carcinoma or melanoma. The mean healing time was 6 weeks. All patients achieved good to excellent functional and aesthetic outcomes. Nearly no ocular-specific complications were observed. Secondary intention healing was well-tolerated by all patients.

Secondary intention healing is a safe and effective alternative to complex reconstructive techniques for selected periorbital defects, particularly in elderly patients. The choice of reconstruction should be tailored individually, taking into account patient age, health status, defect characteristics, and patient preferences.