Intraoperative tissue expansion in eyelid reconstruction

Area of Science:

• Oculoplastic Surgery
• Reconstructive Surgery
• Tissue Engineering

Background:

• Chronic tissue expansion is a standard method for augmenting tissue in reconstructive surgery.
• Rapid intraoperative tissue expansion (RITE) utilizes a tissue expander during surgery to increase tissue availability for defect closure.
• The Foley catheter, an inexpensive and readily available device, has been explored for RITE applications.

Purpose of the Study:

• To evaluate the efficacy and application of the Foley catheter for rapid intraoperative tissue expansion (RITE) in oculoplastic surgery.
• To assess the impact of Foley catheter-assisted RITE on the linear extent of eyelid defects.

Main Methods:

• A case series involving 26 patients (ages 50-87) with eyelid defects requiring reconstruction.
• A modified #14 French Foley catheter with an intact balloon was inserted under a skin-muscle flap.
• The balloon was inflated with saline until flap blanching, with two 5-minute inflation cycles separated by a 1-2 minute rest period.

Main Results:

• The linear extent of eyelid margin defects demonstrated a 36% reduction following RITE.
• This reduction in defect size facilitated easier and more secure wound closure.

Conclusions:

• Rapid intraoperative tissue expansion using a Foley catheter is a viable technique for increasing tissue availability in eyelid and periorbital reconstructive surgery.
• The method provides superior tissue matching for color, texture, and thickness.
• This approach minimizes the need for extensive flap undermining and reduces tension during wound closure.