title: Reconstructive outcomes analysis of lower eyelid and infraorbital skin defects using 2 hatchet flaps: a 6-year experience.
abstract: BACKGROUND
  For the past 6 years, we have used double hatchet flaps for reconstruction of lower lid and infraorbital skin defects.
  
  
  METHODS
  Twenty-five patients who underwent reconstruction of lower eyelid/infraorbital skin defects using double hatchet flaps were retrospectively analyzed. Defect size ranged from 11 × 11 to 15 × 15 mm. In addition, pearls and pitfalls of the technique are discussed along with the presentation of 3 cases.
  
  
  RESULTS
  Flaps were highly viable in all patients. There was no eyelid retraction, scleral show, ectropion, or entropion. Mean follow-up period was 13.7 months. Patient satisfaction with respect to scar appearance was assessed by the standard 5-point scale. Overall patient satisfaction score was 4 (satisfied) in 6 patients, and was 5 (very satisfied) in 19 patients.
  
  
  CONCLUSIONS
  On the basis of the critical review of outcomes in 25 patients, use of double hatchet flaps for the repair of lower lid and infraorbital skin defects gives an excellent functional and aesthetic result. Horizontal movement of the hatchet flaps avoids vertical skin tension in the lower eyelid, and hence minimizes potential complications.
authors.affiliation: From the Departments of *Plastic and Reconstructive Surgery and †Oral and Maxillofacial Surgery, Denver Health Medical Center, University of Colorado Health Sciences Center, Denver, CO.
authors.forename: Raffi
authors.initials: R
authors.lastname: Gurunluoglu
authors.forename: Susan Annette
authors.initials: SA
authors.lastname: Williams
authors.forename: Adam
authors.initials: A
authors.lastname: Olsen
mesh_terms: D000368:Aged; D002280:Basal Cell Carcinoma / Q000601:surgery*; D005142:Eyelid Neoplasms / Q000601:surgery*; D005143:Eyelids / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D013508:Ophthalmologic Surgical Procedures / Q000379:methods*; D017060:Patient Satisfaction; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome