title: Venous Graft for Full-thickness Palpebral Reconstruction.
abstract: Full-thickness palpebral reconstruction is a challenge for most surgeons. The complex structures composing the eyelid must be reconstructed with care both for functional and cosmetic reasons. It is possible to find in literature different methods to reconstruct either the anterior or posterior lamella, based on graft or flaps. Most patients involved in this kind of surgery are elderly. It is important to use easy and fast procedures to minimize the length of the operation and its complications. In our department, we used to reconstruct the anterior lamella by means of a Tenzel or a Mustardé flap, whereas for the posterior lamella, we previously utilized a chondromucosal graft, harvested from nasal septum. Thus, these procedures required general anesthesia and long operatory time. We started using a vein graft for the posterior lamella. In this article, we present a series of 9 patients who underwent complex palpebral reconstruction for oncological reasons. In 5 patients (group A), we reconstructed the tarsoconjunctival layer by a chondromucosal graft, whereas in 4 patients (group B), we used a propulsive vein graft. The follow-up was from 10 to 20 months. The patient satisfaction was high, and we had no relapse in the series. In group A, we had more complications, including ectropion and septal perforations, whereas in group B, the operation was faster and we noted minor complications. In conclusion, the use of a propulsive vein to reconstruct the tarsoconjunctival layer was a reliable, safe, and fast procedure that can be considered in complex palpebral reconstructions.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Ospedale Sant'Anna, Como, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Scevola
authors.affiliation: Department of Plastic and Reconstructive Surgery, Ospedale Sant'Anna, Como, Italy.
authors.forename: Marco Pietro Giuseppe
authors.initials: MP
authors.lastname: Sanna
authors.affiliation: Department of Plastic and Reconstructive Surgery, Ospedale Sant'Anna, Como, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Maxia
authors.affiliation: Department of Plastic and Reconstructive Surgery, Ospedale Sant'Anna, Como, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Esposito
authors.affiliation: Department of Plastic and Reconstructive Surgery, Ospedale Sant'Anna, Como, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Di Giulio
authors.affiliation: Department of Plastic and Reconstructive Surgery, Ospedale Sant'Anna, Como, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Sartore