#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Local Rotating Flaps in Oculoplastic Surgery


Authors: L. Zikmund
Authors‘ workplace: Oční klinika MNUL KZ, prim. MUDr. Ivana Liehneová, Ph. D. ;  Soukromá klinika MEDILAX
Published in: Čes. a slov. Oftal., 72, 2016, No. 3, p. 72-79
Category: Original Article

Overview

Aim:
In the contemporary medicine, strong emphasis is put on early closing of body surface defects, which contributes to good and early healing, but, of course, closes the entrance gate for possible infection as well. The easiest closing of the defect is the direct suture of the emerged wound. But some defects are of such an extent, so their closure is necessary to handle other way than simple suture, e.g. by rotating flap plastic surgery. In the paper are evaluated results of flap surgery technique in 56 patients.

Material and Methods:
It is a retrospective overview of 56 patients operated on by the author in the years 2011–2012, in whom the rotating flap plastic surgery was used as surgery technique. In 46 patients, the reason of flap plastic surgery technique was tumor of the eyelids. In 35 patients, it was due to the basalioma of the lower eyelid, in 8 patients due to the basalioma of the upper eyelid, and in three patients due to the basalioma of the medial cantus region. In 10 patients, the reason of the surgery was ectropion of the lower eyelid, and in two of them bilaterally. The paper is supplemented by surgical procedures photographs, and by a table, with detailed analysis of the sizes of tumors and corresponding flaps as well.

Results:
According to the experience with 56 rotating flap plastic surgeries, performed by author during the period of two years at the Department of Ophthalmology, Masaryk Hospital in Ústí nad Labem, Czech Republic. E.U., the results of the use of rotating skin flaps in 46 eyelids basalioma, of correcting 12 ectropions of the lower eyelid, and reliability of the tumor’s excision with 2 mm surrounding healthy tissue rim were followed-up. Using the mentioned surgery technique, it was possible in all patients to secure the closing of the eyelid defect, or to return to normal and correct anatomical position of the eyelids in ectropions. In two patients with basalioma of the lower eyelid, the additional technique of lateral cantotomy was used to relieve the tension in the wound. Statistical results of recurrences number in tumors’ excisions with 2 mm safety margin in to the healthy tissue confirm the relative safety of such wide excision, and our results (4.34 %) differ only slightly from the results published in the literature (4.0 %).

Key words:
flap plastic surgery, basalioma, ectropion


Sources

1. Elshammaa Nourhan A., et al.: The use of forehead flaps in the management of large basal cell carcinomas of the medial canthus/medial lower eyelid in Saudi patients. Saudi Journal of Ophthalmology, 2013, 27.3: 223–225.

2. Furdová, A. Horkovičová, K. Babál, P. et al.: Nemelanómové nádory kože mihalníc a vnútorného kútika – bazocelulárny karcinóm. Čes a slov Oftalmol, 2015; 71: 293–301.

3. Furdová, A., Lukačko, P., Lederlaitner, D.: HDR 192Ir brachyterapia v liečbe bazocelulárneho karcinómu dolnej mihalnice a vnútorného kútika oka – naše skúsenosti. Čes a slov Oftalmol, 2013; 69: 75–79.

4. Krásný, J., Šach, J., Brunnerová, R. et al.: Orbitální tumory u dospělých – desetiletá studie. Čes a slov Oftalmol, 2008; 64: 219-227.

5. Timothy K. Chartier, Sumaira Z. Aasi, Rosamaria Corona: Treatment and prognosis of basal cell carcinoma at low risk of recurrence. Uptodate. UpToDate (cited 13 May, 2013). Available from URL: http://www. uptodate. com/contents/Treatment-and-prognosis-of-basal-cell-carcinoma-at-low-risk-of-recurrence, 2013.

6. Tijl, J. W., Koornneef, L.: [The surgical treatment of basal cell carcinoma of the eyelids]. Nederlands tijdschrift voor geneeskunde, 1991, 135.11: 471–474.

7. Telfer, N. R., Corvert, G. B., Morton, C. A.: Guidelines for the management of basal cell carcinoma. Brit J Dermatol, 2008, 159.1: 35–48.

8. Wang, Y. C., et al.: Pedicled lower lid-sharing flap for full-thickness reconstruction of the upper eyelid. Eye, 2014, 28.11: 1292–1296.

9. Weinzweig, N., Weinzweig, J.: Basic principles and techniques in plastic surgery. Mastery of Plastic and Reconstructive Surgery. 1st ed. New York: Little Brown, 1994, 14–33.

10. Wu, P. A.: Epidemiology and clinical features of basal cell carcinoma. Uptodate. UpToDate (cited 13 May, 2013). Available from URL: http://www. uptodate. com/contents/epidemiology-and-clinical-features-of-basal-cell-carcinoma, 2013.

Labels
Ophthalmology
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#