Thursday, February 24, 2011

Reconstruction of Traumatic Loss of Upper Eyelid

As mentioned earlier this patient lived across the border in Kalimantan, Indonesia, I decided to choose a technique that required no revision (2-stage reconstruction) in case he failed to return for follow-up. The technique I chose was reversed Tenzel's flap. 

Traumatic loss of the upper eyelid from road traffic accident.
The patient was referred from another medical centre.

Marking of the Tenzel's flap. Arrow shows loss of the skin
on the nasal stump of the eyelid.

The ends of the eyelid were pulled tight to determine the amount
of tissue needed to bridge the gap.

Creation of the flap.

The two ends were sutured tarsal plate to tarsal plate.

Arrows show area of skin loss that needs to be covered.
This was achieved by using advancement flap.

At the end of the operation.

Apperance of the eye the next day.

Side view of the face. The eye should open spontaenously
over the next two to three weeks.

He returned to Kalimantan the day after the operation. I shall report his progress in my next blog if he returned for follow-up.  

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