应用整形美容外科原则修复上睑创伤的效果观察

Observation on efficacy of principles of plastic and cosmetic surgery in the repair of upper eyelid trauma

目的探讨应用整形美容外科处理原则修复急诊上睑创伤的临床效果。方法自2017年10月至2019年9月,西京医院整形外科对28例(30只眼)急诊上睑外伤的患者采用整形美容技术修复,遵循无创、无张力及无死腔等原则,对不同的创伤情况实施相应的修复方法。结果所有患者的伤口均一期愈合,术后获随访3~12个月,1例左眼睑重度上睑下垂伴睑缘成角畸形;1例左上睑术后瘢痕挛缩导致上睑形态欠佳,其余患者对外观均较满意,创口瘢痕细微,无睑缘成角畸形、眼睑内外翻、结膜脱垂、倒睫、眼睑闭合不全、上睑下垂等并发症。结论对急诊上睑外伤的患者,应用整形美容处理原则行及时、细致的清创后再精细缝合,可有效地维持眼睑结构的完整、促进功能及外观的恢复。

Objective To explore the clinical efficacy of principles of plastic and cosmetic surgery in the repair of upper eyelid trauma in emergency.Methods From October 2017 to September 2019,28 patients(30 eyes)with upper eyelid trauma were repaired by plastic and cosmetic techniques,which followed the principles of non-invasive,non-tension and non-dead space.The corresponding repair methods were applied to different traumatic conditions.Results All wounds healed in one stage.All patients were followed up for 3 to12 months.There was 1 case of severe ptosis of left eyelid and angular deformity of eyelid margin.There was 1 case of poor appearance of upper eyelid caused by scar contraction after operation.The remaining patients were satisfied with the appearance.The scar in wounds was slight,no complications such as angular deformity of eyelid margin,entropion or ectropion of eyelid,conjunctival prolapse,trichiasis,incomplete closure of eyelids and ptosis occurred.Conclusion For patients with upper eyelid trauma,the application of principles of plastic and cosmetic surgery in timely and meticulous debridement and fine suture can effectively maintain the integrity of eyelid structure and promote the recovery of function and appearance.