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Reconstruction of Large Upper Eyelid Defects Using the Reverse Hughes Flap Combined With a Sandwich Graft of an Acellular Dermal Matrix

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Abstract
PURPOSE: To investigate the usefulness of the reverse Hughes flap procedure combined with a sandwich graft of an acellular dermal matrix for reconstruction of large full-thickness defects of upper eyelids after cancer excision. METHODS: Clinical data were obtained from patients who underwent upper eyelid reconstruction using a reverse Hughes flap combined with a sandwich graft of an acellular dermal matrix (AlloDerm) as a tarsal substitute. The tarsoconjunctival flap of the donor lower eyelid was mobilized to reconstruct the posterior lamella, and acellular dermal matrix was grafted onto the tarsoconjunctival flap. A skin-orbicularis muscle flap superior to the defect was advanced to cover the acellular dermal matrix graft, followed by application of lid crease formation sutures to prevent postoperative entropion. The tarsoconjunctival pedicle was divided 3-8 weeks after the surgery. RESULTS: Six patients with sebaceous carcinoma were included, and all had ≥70% full-thickness upper eyelid defects after tumor excision. After a median follow-up of 40 months (range 6-62 months), all 6 showed satisfactory functional and cosmetic outcomes. Tumor recurrence, exposure keratopathy, upper eyelid entropion, persistent use of bandage contact lenses, lower eyelid deformity, and dermal matrix-related complications were not observed by the last follow-up. CONCLUSIONS: Reverse Hughes flap combined with a sandwich graft of an acellular dermal matrix as a tarsal substitute was successful in reconstructing large upper eyelid defects. Acellular dermal matrix graft and lid crease formation sutures enhance marginal stability and prevent postoperative entropion of the reconstructed upper eyelid.
Author(s)
어규상사호석
Issued Date
2021
Type
Article
Keyword
Medical collegesUsage
DOI
10.1097/IOP.0000000000001779
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7660
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2432863815&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Reconstruction%20of%20Large%20Upper%20Eyelid%20Defects%20Using%20the%20Reverse%20Hughes%20Flap%20Combined%20With%20a%20Sandwich%20Graft%20of%20an%20Acellular%20Dermal%20Matrix&offset=0&pcAvailability=true
Publisher
OPHTHALMIC PLASTIC AND RECONSTRUCTIVE SURGERY
Location
미국
Language
영어
ISSN
0740-9303
Citation Volume
37
Citation Number
3
Citation Start Page
S27
Citation End Page
S30
Appears in Collections:
Medicine > Medicine
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