Incidence of host site complications in periocular full thickness skin grafts
Incidence of host site complications in periocular full thickness skin grafts
复制标题
DOI：
10.1136/bjo.2004.052639
复制
发表时间：
2005-02-01
影响因子：
4.1
通讯作者：
Selva, D
中科院分区：
文献类型：
--
作者：
Leibovitch, I;Huilgol, SC;Selva, D
目的：为了评估并发症的眼周全层皮肤移植（FTSG）的莫氏显微手术（MMS）治疗的患者的眼周malignancy.Method：这一前瞻性，多中心的病例系列包括所有患者在澳大利亚治疗的MMS眼周恶性肿瘤，然后重建与FTSG，谁是监测皮肤和癌症基金会，在1993年和1999年之间。记录的参数包括患者的人口统计学资料、转诊原因、恶性肿瘤的组织学分类和神经周围浸润的证据、肿瘤持续时间、部位、MMS前复发、术前肿瘤大小和术后缺损大小。FTSG供体部位包括上眼睑、耳前、耳后、内臂和锁骨上。主要结局指标为FTSG宿主部位并发症（部分/完全移植物衰竭、移植物感染、急性出血/血肿、移植物肥大和移植物挛缩）。结果：397例患者（229例男性，168例女性），平均年龄60（SD 15）岁（范围20-91岁）。基底细胞癌占92.7%，Bowen病占2.0%，鳞状细胞癌占3.3%。内眦受累占66.5%，下睑受累占28.0%，上睑受累占5.5%。62例患者（占所有患者的15.6%）记录了术后并发症，包括移植物肥大（占并发症的45.1%）、移植物收缩（29.1%）和部分移植物衰竭（12.9%）。唯一有统计学意义的相关性是内眦重建中移植物肥大的发生率较高（p = 0.007）。结论：眼周FTSG的宿主部位并发症并不常见。移植物肥大是大多数并发症的原因，并且在内眦区域更常见。没有其他变量，如患者人口统计学，肿瘤特征，或供体部位因素与并发症的风险较高。
Aim: To evaluate the complications of periocular full thickness skin grafts (FTSG) in patients treated with Mohs' micrographic surgery (MMS) for periocular malignancy.Method: This prospective, multicentre case series included all patients in Australia treated with MMS for periocular malignancy followed by reconstruction with FTSG, who were monitored by the Skin and Cancer Foundation, between 1993 and 1999. The parameters recorded were patient demographics, reason for referral, histological classification of malignancy and evidence of perineural invasion, duration of tumour, site, recurrences prior to MMS, preoperative tumour size, and postoperative defect size. FTSG donor sites included upper lid, preauricular, retroauricular, inner brachial, and supraclavicular. The primary outcome measures were FTSG host site complications (partial/complete graft failure, graft infection, acute bleeding/haematoma, graft hypertrophy, and graft contracture).Results: 397 patients ( 229 males, 168 females), mean age 60 (SD 15) years (range 20-91 years). 92.7% were diagnosed with basal call carcinoma, 2.0% with Bowen's disease, and 3.3% with squamous cell carcinoma. Medial canthus was involved in 66.5% of patients, lower eyelid in 28.0%, and upper eyelid in 5.5%. Postoperative complications were recorded in 62 patients (15.6% of all patients), and consisted of graft hypertrophy (45.1% of complications), graft contraction (29.1%), and partial graft failure (12.9%). The only statistically significant association found was a higher rate of graft hypertrophy in medial canthal reconstruction (p = 0.007).Conclusion: Host site complications of periocular FTSG are not common. Graft hypertrophy accounted for most complications and was more common in the medial canthal area. No other variables such as patient demographics, tumour characteristics, or donor site factors were associated with a higher risk of complications.