Comparative evaluation of engraftment of a complex transplant and recovery of local blood flow after various methods of reconstructive blepharoplasty
P.A. BANSHCHIKOV1, V.V. EGOROV1,2, G.P. SMOLYAKOVA1,2
1Khabarovsk branch of the S. Fyodorov Eye Microsurgery Federal State Institution, 211 Tikhookeanskaya Str., Khabarovsk, Russian Federation, 680033
2Institute for Advanced Training of Health Professionals, 9 Khabarovskaya Str., Khabarovsk, Russian Federation, 680000
Contact:
Banshchikov P.A. ― Head of the reconstructive plastic surgery department, tel. (4212) 72-27-92, e-mail: naukakhvmntk@mail.ru
Egorov V.V. ― D. Med. Sc., Professor, Director of the Khabarovsk branch of S. Fyodorov Eye Microsurgery Federal State Institution, Head of the ophthalmology department of Institute for Advanced Training of Health Professionals, tel. (4212) 22-51-21, e-mail: naukakhvmntk@mail.ru
Smolyakova G.P. ― D. Med. Sc., Professor, Ophthalmologist of the clinical-expert department of the Khabarovsk branch of S. Fyodorov Eye Microsurgery Federal State Institution, professor of the ophthalmology department of Institute for Advanced Training of Health Professionals, tel. (4212) 22-51-21, e-mail: naukakhvmntk@mail.ru
The processes of engraftment and recovery of local blood flow at one-stage reconstructive blepharoplasty with the use of various complex transplants are studied in the article.
The subject of study were 30 patients (30 eyes) with extensive through eyelid defects. The age of patients ranged from 27 to 68 years. The main group consisted of 15 patients (15 eyes), whom the closure of extensive through eyelid defects was carried out using triplex complex transplants. The control group consisted of 15 patients (15 eyes), for whom closure of eyelid defects was carried out using double-layer transplant.
Criteria for evaluation the effectiveness of processes of engraftment of various complex transplants were: color of skin transplant, clinical characteristics of the scar, frequency of outcomes with deforming scars. Speed of recovery of local blood flow in surgery zone was assessed by laser doppler flowmetry.
A month after operation in patients of the main group the reparative process came to the end with formation of a gentle thin scar with a width 2.0-2.5 mm. Color of skin transplant was identical to nearby tissues. Only in 5 patients of the control group a month after operation process came to the end with formation of a thin scar on border of transplant.
In the long-term postoperative period (12 months), the correct position of the eyelids with no difference in the size of the palpebral fissure was noted in 12 patients of the main group. In 2 patients, an increase in the size of the palpebral fissure to «+» 11%, partial ectropion of eyelid, retraction were revealed. In the control group, 5 patients had an incorrect position of the operated eyelid (retraction, ectropion, entropion).
In prospective comparative study, it was found that using triplex complex transplants provides in 80% of the operated patients a complete restoration of normal position and good functional activity of eyelids without additional surgical correction, versus 66.7% in the control group. Improvement in the quality of scarring was achieved by 49%.
Key words: blepharoplasty, eyelid defects, temporal muscle, local blood flow.
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