纵向切口横向缝合法在下眼睑缘五边形全层缺损修复中的应用

Application of transverse closure of longitudinal incisions in reconstructing pentagonal full-thickness defects of the lower eyelid margin

目的探讨纵向切口横向缝合法在下眼睑缘五边形全层缺损修复中的应用。方法回顾分析2016年7月至2019年6月杭州市第三人民医院皮肤科26例下眼睑睑缘黑素细胞痣患者的临床资料。26例中, 男10例, 女16例, 病灶切除后的五边形缺损全采用纵向切口横向缝合法修复。结果 26例患者五边形缺损均得到成功修复, 垂直于眼睑的纵向切口转变为平行于睑缘和紧临睫毛下方的横向切口, 均达到Ⅰ期愈合, 3例下眼睑术后轻度淤血, 1例术后暂时性视物模糊。术后随访1 ~ 2年, 26例患者双侧眼周皮肤软组织外观对称, 术后瘢痕不明显, 无下眼睑外翻。结论纵切横缝法修复下眼睑缘五边形全层缺损, 能将纵向垂直于下睑缘的切口闭合线转换为与下睑缘平行的水平横向切口闭合线, 达到隐藏下眼睑切口和瘢痕的效果。

Objective To investigate the application of transverse closure of longitudinal incisions in repairing pentagonal full-thickness defects of the lower eyelid margin.Methods A retrospective analysis was performed on clinical data collected from 26 patients with melanocytic nevi at the lower eyelid margin in Department of Dermatology,The Third People's Hospital of Hangzhou from July 2016 to June 2019.Among the 26 patients,10 were males,and 16 were females.After lesion resection,all the pentagonal full-thickness defects of the lower eyelid margin were repaired via transverse closure of longitudinal incisions.Results All the pentagonal defects of the 26 cases were successfully repaired.The longitudinal incisions perpendicular to the eyelid were successfully converted into transverse incisions parallel to the eyelid margin and near the eyelash,and all incisions healed primarily.After surgery,mild congestion of the lower eyelid occurred in 3 patients,and temporary blurred vision in 1.During 1-2 years of postoperative follow-up,26 patients all achieved symmetrical appearance of the skin and soft tissues around the eyes,without obvious postoperative scars or lower eyelid ectropion.Conclusions Horizontal closure of longitudinal incisions can be used to repair the pentagonal full-thickness defects of the lower eyelid margin,because it can convert the incision closure line perpendicular to the lower eyelid margin into a horizontal transverse incision closure line parallel to the lower eyelid margin,so that the incisions and scars of the lower eyelid can be hided with a satisfactory cosmetic effect.