title: Full thickness skin grafts in periocular reconstructions: long-term outcomes.
abstract: OBJECTIVE
  To evaluate the outcomes of eyelid reconstruction in patients who underwent full thickness skin grafts.
  
  
  METHODS
  A retrospective, noncomparative intervention study of patients who underwent periocular reconstruction with full thickness skin grafts between 2005 and 2011.
  
  
  RESULTS
  One hundred consecutive Caucasian patients were included in the study, 54 women and 46 men. Mean follow up was 32 months. Indications for full thickness skin grafts were excision of eyelid tumors (98%) and cicatricial ectropion (2%). Site of lid defects were lower lid (60%), medial canthus (32%), upper lid (6%), and lateral canthus (2%). The skin graft donor sites were supraclavicular (44%), upper eyelid (24%), inner brachial (18%), and postauricular (14%).Early postoperative complications included lower eyelid graft contracture (1%) and partial failure (1%). Late sequelae included lower eyelid graft contracture (4%) and hypertrophic scarring (23%). Of the 23 patients with hypertrophic scar, 21 achieved good outcomes following massage with silicone gel and steroid ointment and 2 had persistent moderate lumpiness. No statistically significant association was found between graft hypertrophy and donor site or graft size. As high as 95% of all patients achieved good final eyelid position. Good color match was seen in 94% and graft hypopigmentation in 6%. An association between hypopigmentation and supraclavicular and inner brachial donor site was found to be statistically significant.
  
  
  CONCLUSIONS
  Most patients (94%) achieved good eyelid position and color match. Majority (91%) of the early postoperative cicatricial sequelae can be reversed by massage, steroid ointment, and silicone gel application. Full thickness skin grafts have excellent graft survival rates and have minimal donor site morbidity.
authors.affiliation: Department of Ophthalmology, University Hospital of Coventry and Warwickshire, Warwick Medical School, Clifford Bridge Road, Coventry, United Kingdom.
authors.forename: Deepa S
authors.initials: DS
authors.lastname: Rathore
authors.forename: Swaroop
authors.initials: S
authors.lastname: Chickadasarahilli
authors.forename: Richard
authors.initials: R
authors.lastname: Crossman
authors.forename: Purnima
authors.initials: P
authors.lastname: Mehta
authors.forename: Harpreet Singh
authors.initials: HS
authors.lastname: Ahluwalia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005141:Eyelid Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D012880:Skin Pigmentation; D016038:Skin Transplantation; D013536:Suture Techniques