Controlled tissue expansion in periocular reconstructive surgery.
BACKGROUND
Soft tissue expansion is a technique useful in reconstruction when a shortage of tissue exists. This method allows the creation of skin similar in appearance and type to that immediately adjacent to the defect. The use of this technique as a stage in repairing large periocular defects is presented. The sequence of implant placement, expansion, and ensuing eyelid reconstruction is illustrated.


METHODS
The soft tissue adjacent to an eyelid defect was expanded by means of a subcutaneously implanted reservoir that was progressively inflated over several weeks by percutaneous injection of fluid. The prosthesis was removed after adequate expansion had been achieved. The expanded tissue was then used to fashion a local flap to resurface the defect.


RESULTS
Upper eyelid skin expansion was performed in one patient, and five patients received expansion in an adjacent area. The expanded tissue was then used to reconstruct the eyelid defect. The only complications encountered were tissue necrosis at the tip of an advancement flap in one patient and hematoma formation within the dissection pocket after expander insertion in another patient.


CONCLUSIONS
This technique complements existing reconstructive methods and provides a valuable surgical alternative for managing various periocular defects. The potential application of this technique in eyelid and periocular reconstruction appears promising.
Tse
D T
DT
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Florida 33101.
McCafferty
L R
LR
D000293:Adolescent; D000328:Adult; D000368:Aged; D005131:Eye Injuries / Q000601:surgery; D005138:Eyebrows / Q000601:surgery*; D005142:Eyelid Neoplasms / Q000601:surgery; D005143:Eyelids / Q000293:injuries / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery; D011183:Postoperative Complications; D013518:Surgery, Plastic / Q000379:methods*; D015626:Tissue Expansion / Q000379:methods*; D015625:Tissue Expansion Devices