利用Integra真皮再生模板进行眼周重建。

IF 1.3 4区 医学 Q3 OPHTHALMOLOGY
Liane O Dallalzadeh, Anne L Bennett, Mikaela Kislevitz, Phillip A Tenzel, Ronald Mancini, Kamel Itani, James F Thornton
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引用次数: 0

摘要

目的:描述使用Integra真皮再生模板(DRT)在莫氏显微摄影或手术切除皮肤恶性肿瘤后的眼周重建。方法:这是一项回顾性研究,对2017年至2023年在单一学术机构接受DRT眼周重建的成年患者进行研究。所有患者术后均有至少1个眼周亚基缺损,包括眉毛、太阳穴、脸颊、鼻侧壁、内侧和/或外侧眦区。主要观察指标是术后瘢痕性眼睑错位的发生率。结果:纳入16例患者(男性62.5%,年龄70.6±11.3岁[mean±SD])。术后缺损平均为27.0±21.4 cm2, 13例(81.3%)患者的缺损累及1个以上眼周亚基,以内侧眦区和鼻侧壁最常见(37.5%)。最后切除阶段到达骨膜/骨的4例,等待边缘清除的3例,侵犯神经周围的2例,医学上不适合全麻的3例,选择DRT进行分期重建。再上皮化发生在DRT放置后34±8天,无论是全层或裂层皮肤移植,还是邻近组织转移。瘢痕性眼睑移位9例(56.3%),以眉部和鼻侧壁发生率最高。再上皮化程度与体位异常发生率无显著相关性(p = 0.87)。结论:这一系列研究证明了DRT在皮肤恶性肿瘤切除术后大面积眼周缺损重建中的应用,特别是在重建时缺乏病理清除的情况下。继发眼睑错位的发生率并非微不足道,值得术前讨论。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Periocular Reconstruction Utilizing the Integra Dermal Regeneration Template.

Purpose: To describe the use of the Integra dermal regeneration template (DRT) for periocular reconstruction following Mohs micrographic or surgical excision of cutaneous malignancy.

Methods: This is a retrospective study of adult patients who underwent periocular reconstruction using DRT from 2017 to 2023 at a single academic institution. All patients had a postexcision defect involving at least 1 periocular subunit, including brow, temple, cheek, nasal sidewall, medial and/or lateral canthal areas. The primary outcome measure was the incidence of postoperative cicatricial eyelid malposition.

Results: Sixteen patients were included (62.5% male, 70.6 ± 11.3 years old [mean ± SD]). Mean postexcision defect measured 27.0 ± 21.4 cm2, with 13 patients (81.3%) having a defect that involved more than 1 periocular subunit, with medial canthal area and nasal side wall being most common (37.5%). DRT was chosen for staged reconstruction for 4 cases where the final stage of excision reached periosteum/bone, 3 cases awaiting clearance of margins, 2 cases of perineural invasion, and 3 cases medically unfit to undergo general anesthesia, when specified. Re-epithelialization occurred 34 ± 8 days following DRT placement with either full thickness or split thickness skin graft, or adjacent tissue transfer. Nine patients (56.3%) developed cicatricial eyelid malposition, with the brow and nasal side wall having the greatest incidence. Means of re-epithelialization was not significantly associated with the incidence of malposition (p = 0.87).

Conclusions: This series demonstrates DRT's utility in the reconstruction of large periocular defects following excision of cutaneous malignancy, particularly cases that lack pathological clearance at the time of reconstruction. The incidence of subsequent eyelid malposition is not insignificant and merits preoperative discussion.

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来源期刊
CiteScore
2.50
自引率
10.00%
发文量
322
审稿时长
3-8 weeks
期刊介绍: Ophthalmic Plastic and Reconstructive Surgery features original articles and reviews on topics such as ptosis, eyelid reconstruction, orbital diagnosis and surgery, lacrimal problems, and eyelid malposition. Update reports on diagnostic techniques, surgical equipment and instrumentation, and medical therapies are included, as well as detailed analyses of recent research findings and their clinical applications.
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