title: Upper Blepharoplasty and Lateral Wound Dehiscence.
abstract: OBJECTIVE
  To report the frequency of lateral wound dehiscence (LWD) after upper blepharoplasty (UB), a technique and its outcome to prevent LWD.
  
  
  METHODS
  A retrospective review was performed for cases of LWD after UB presenting between 2003 and 2009, and then a prospective comparative study was performed between February 2009 and March 2013. For the comparison, subjects were divided into two groups based on intraoperative assessment of lateral wound tension (same technique and surgeon). Group 1 received 1-3 orbicularis/subcutaneous buried sutures (6-0 polyglactin) before interrupted 6-0 nylon skin closure. Group 2 underwent skin closure only. Subjects, who had re-operation, skin healing disorders, and incomplete follow-up (<6 months), were excluded. P < 0.05 was considered as statistically significant.
  
  
  RESULTS
  There were 14 (14/678, 2%) cases with LWD with a mean age of 36.2 years in the audit (2003-2009). The prospective study included 68 subjects (68/293, 23.2%) in Group 1 and 225 in Group 2. Gender and simultaneous forehead and eyebrow procedures were similar between groups (P = 0.3 and P = 0.4 respectively). Group 1 was statistically significantly younger at mean age of 41.4 years, compared to Group 2 at 56.1 years (P = 0.000). The frequency of LWD significantly (P = 0.04) decreased to 0.3% (1/293).
  
  
  CONCLUSIONS
  In the presence of wound tension on skin closure (intraoperative assessment), tension relieving buried orbicularis/subcutaneous 6-0 polyglactin suturing of the lateral UB incision could prevent LWD.
authors.affiliation: Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohsen Bahmani
authors.initials: MB
authors.lastname: Kashkouli
authors.affiliation: Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Mansooreh
authors.initials: M
authors.lastname: Jamshidian-Tehrani
authors.affiliation: Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Sahab
authors.initials: S
authors.lastname: Sharzad
authors.affiliation: Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Mostafa Soltan
authors.initials: MS
authors.lastname: Sanjari
mesh_terms: D000328:Adult; D019882:Blepharoplasty / Q000009:adverse effects*; D005143:Eyelids / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D013529:Surgical Wound Dehiscence / Q000209:etiology*; D013536:Suture Techniques; D014945:Wound Healing; D055815:Young Adult
keywords: Blepharoplasty; Eyebrow Ptosis; Lateral Hooding; Upper Blepharoplasty; Wound Dehiscence