Time-trend analysis of 78 orbicularis oculi myocutaneous flaps in periorbital reconstruction: a single-center retrospective study in South Korea.

Abstract

Background: The orbicularis oculi myocutaneous (OOMC) flap offers an excellent match in color, thickness, and texture for periorbital defects, yet large-scale, long-term data remain scarce. To determine whether indications, flap‑design preferences, and complication profiles change as surgical experience accumulates, cases were stratified into an early practice phase (2001-2017) and a contemporary phase following technique refinement and wider adoption (2018-2024).

Methods: All periorbital reconstructions utilizing OOMC flaps between November 2001 and December 2024 were retrospectively reviewed. Cases were stratified into Group A (2001-2017) and Group B (2018-2024). We analyzed patient age, sex, etiology, defect site/number, flap design (V-Y advancement, unipedicle/bipedicle switch, pivot), adjunctive procedures, and complications.

Results: Seventy-eight OOMC flaps were performed in 57 patients for 70 defects. Group A included 25 patients, 30 defects, and 36 flaps, while Group B included 32 patients, 40 defects, and 42 flaps. Basal cell carcinoma was the leading etiology in both periods (77%). The proportion of V-Y advancement flaps rose from 50% (18/36) in Group A to 83% (35/42) in Group B. No flap necrosis occurred, and tumor recurrence was observed only once in Group A.

Conclusion: Despite the relatively short observation window for Group B, OOMC flap use increased markedly, confirming that accumulated surgical experience promotes even more frequent application in periorbital reconstruction. The V-Y advancement variant, in particular, expanded in indication without added morbidity and appears highly reliable for a broad spectrum of periorbital defects.