Repair of eyelid anterior layer defect
Defects in the anterior layer of the eyelid refer to the orbital skin and the orbicularis oculi muscle, and the anterior layer of tissue defects need to be reshaped before repairing, which is easy to repair. Treatment of diseases: congenital eyelid defects Indication Localized anterior layer defects. Surgical procedure Repair of triangular defect in the anterior eyelid 1. Renovate the anterior layer of the eyelid into a triangular defect wound. On both sides of the tumor site, the intercondylar lips are opened, and the eyelids are two layers. 2. Sneak the subcutaneous tissue around the wound edge and the orbicularis oculi muscle to make it fully loose, then pull the layered suture. Repair of rectangular defect in the front of the eyelid Transition flap repair 1. After the tumor is removed, the defect wound is reshaped into a rectangle. If the defect is in the center of the eyelid, a certain range of the intercondylar lip is opened to the sides, and the range is determined according to the defect range. Another incision was made at the lower edge of the tumor along the parallel margin, and the skin and the orbicularis muscle were cut. The orbicularis muscle and the tarsal plate are sneaked apart to form a strip-shaped flap. 2. Pull the flaps on both sides to the wound surface, cover the defect wound, and suture intermittently. 3. If the cat's ear phenomenon occurs after the flap is pulled and sutured at the distal end of the incision, a triangular skin is removed from the distal end of the upper and lower incision to make it flat and intermittently sutured. 4. If the defect is located on the nasal side, the transition flap is placed on the temporal side of the wound. 5. If the defect is relatively narrow and long, it is difficult to draw the suture even if the flaps are made on both sides. A moving flap can be made under the narrow rectangular flap. This situation can often be encountered when squatting. Translocation flap repair Generally, the lower iliac crest can be repaired as a cheek or upper metatarsal translocation flap. The lower nasal side can be repaired with a translocation flap at the central part of the lower jaw. The upper temporal wound can be repaired with a translocation flap of the forehead. The upper nasal side of the wound was repaired with a nasal root or frontal translocation flap. If the wound is wider and it is difficult to use the upper method, it can be designed to repair the translocation flaps that are connected at both ends. The surgical procedure is to repair the anterior layer of the lower jaw: 1. After the wound is repaired, the translocation flap is made downward or upward on the temporal side of the defect wound. The width and length should be larger than the actual defect wound surface, generally 1/4 to 1/3 larger, pay attention to the translocation flap. The ratio of the pedicle to the length is preferably no more than 1:2.5. Separating the subcutaneous tissue beneath the translocation flap can result in adipose tissue beneath the translocation flap. Fully separate the subcutaneous tissue around the wound. 2. Improve bleeding. The translocation flap was transposed to cover the defect wound and sutured intermittently. The defect of the translocation flap was sutured. Free skin graft The following is a large range of pigmented nevus. Surgical steps: 1. Excision of the sputum pigmentation. Renovate the wound. According to the size and shape of the wound, a full-thickness skin piece is cut on the back of the ear, the inner side of the upper arm or the neck clavicle. If the wound surface is large, the medium-thickness skin piece can be cut inside the thigh. 2. After the eyelid wound is fully hemostasis, the free skin piece is placed in the lower jaw wound surface, and the shape of the skin piece is repaired while the side is broken. Three to four pairs of corresponding long-line heads are left in the suture around the wound edge. 3. Make 1 or 2 small drainage incisions on the surface of the skin, and evenly spread the surface of the skin with a twisted alcohol spun yarn or a fine yarn impregnated with antibiotics, and ligature the corresponding long yarn to fix the surface of the skin. Ligation), after the surface is covered with gauze, the bandage is bandaged.
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