Clinical Application of Eyelid Composite Tissue Flap in the Repair of Full-thickness Eyelid Margin Defects

Full-thickness eyelid margin defects resulting from tumor resection present a significant reconstructive challenge, necessitating techniques that balance functional restoration with aesthetic outcomes. This study evaluates the efficacy of the eyelid composite tissue flap advancement technique in addressing these challenges.

In this retrospective case series, 85 patients with eyelid margin tumors underwent reconstruction using the described technique. Following tumor excision, which was tailored based on the pathological diagnosis (75 pigmented nevi, 8 basal cell carcinomas, 2 squamous cell carcinomas), bilateral full-thickness eyelid flaps were created parallel to the defect. Key surgical steps included the precise incorporation of the marginal arterial arcade to ensure vascularity and layered anatomical closure. The primary outcomes assessed were flap survival, eyelid function, aesthetic results, and patient satisfaction.

All 85 flaps survived completely, with primary healing achieved in all cases. The functional integrity of the repaired eyelids was maintained, and the aesthetic appearance was rated as natural or satisfactory. No major complications, such as significant notching, ectropion, or lagophthalmos, were observed during the follow-up period.

The eyelid composite tissue flap advancement technique is a reliable and effective single-stage procedure for reconstructing full-thickness defects involving up to two-thirds of the eyelid length. Its robust blood supply and ability to restore the natural anatomical layers make it an ideal choice for this indication, yielding high survival rates and satisfactory functional and cosmetic outcomes.