How and when of eyelid reconstruction using autologous transplantation.
How and when of eyelid reconstruction using autologous transplantation.
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DOI：
10.5500/wjt.v12.i7.175
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发表时间：
2022-07-18
期刊：
影响因子：
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通讯作者：
Parodi, Pier Camillo
中科院分区：
文献类型：
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作者：
Miotti, Giovanni;Zeppieri, Marco;Rodda, Agostino;Salati, Carlo;Parodi, Pier Camillo
肿瘤切除、创伤或其他原因后的眼睑重建手术可能具有挑战性，特别是由于解剖结构的复杂性以及功能和美学成功结果的必要性。本文旨在探讨组织移植在眼睑重建中的应用。外科手术是多种多样的，基于带蒂或游离皮瓣和移植物的使用，以保证适当的组织重建和血液供应，这是正确愈合所必需的。常见的技术通常包括使用局部组织，将非血管化移植物与血管化皮瓣结合用于两个椎板修复，以尝试类似于原始解剖结构的重建。当缺损太宽、太大、太深和太复杂时，或者当没有邻近的健康组织可用时，需要将远端区域组织作为游离皮瓣或移植物招募，并与粘膜层重建配对。对于前板层，通常首选全层皮肤移植。关于后板的重建，有不同的移植选择，包括结膜或睑板结膜，粘膜或腭或软骨移植，通常与局部皮瓣结合。游离皮瓣移植，通常保留在罕见的选择情况下，包括使用前臂桡侧和前外侧皮瓣结合粘膜移植，这是目前文献报道的手术选择。
Reconstructive surgery of the eyelid after tumor excision, trauma or other causes can be challenging, especially due to the complexities of the anatomic structures and to the necessity of both functional and aesthetic successful outcomes. The aim of this minireview was to investigate the use of tissue transplantation in eyelid reconstruction. Surgical procedures are various, based on the use of both flaps, pedicled or free, and grafts, in order to guarantee adequate tissue reconstruction and blood supply, which are necessary for correct healing. Common techniques normally include the use of local tissues, combining non-vascularized grafts with a vascularized flap for the two lamellae repair, to attempt a reconstruction similar to the original anatomy. When defects are too wide, vast, deep, and complex or when no adjacent healthy tissues are available, distant area tissues need to be recruited as free flaps or grafts and paired with mucosal layer reconstruction. With regards to the anterior lamella, full thickness skin grafts are commonly preferred. With regards to the reconstruction of posterior lamella, there are different graft options, which include conjunctival or tarsoconjunctival, mucosal or palatal or cartilaginous grafts usually combined with local flaps. Free flap transplantation, normally reserved for rare select cases, include the use of the radial forearm and anterolateral flaps combined with mucosal grafts, which are surgical options currently reported in the literature.