The ectropion and adduction of lower eyelid after burn have been treated by progressive reconstruction surgery. (Photo courtesy of Linkou Chang Gung Hospital) Sequelae of scar contracture after burn: lower eyelid retracts and lower eye whites are exposed.
50-year-old Ms. Wei, with 2-3 degree burns on 60% of her body surface, survived after repeated debridement and skin grafting at Chang Gung Burn Center in Linkou. The scar after wound healing has an impact on Ms. Wei's face, trunk and limbs, especially her face. Scar contracture after burn leads to bilateral lower eyelid atrophy, and the lower eye is white.
Because of the burn around the eyes, the doctor suggested that the patient should undergo lateral canthus plastic surgery and lower eyelid skin grafting. Dr. Chen Hongzhang, from the Department of Plastic Surgery, Chang Gung Hospital, Linkou, said that after the scar contracture of the lower eyelid was released, the outer canthus was fixed in the correct position to prevent the lower eyelid from everting and shrinking again. The missing skin of the lower eyelid was transplanted from the supraclavicular skin.
Doctors usually transplant facial skin, which will be closer to the skin color around the eyes. However, because Ms. Wei has a scar on her face and no complete skin, she used the skin on her collarbone for transplantation. The general anesthesia operation lasted for 3 hours and was discharged one week after operation. He recovered well. After a week's follow-up, 100% of the transplanted skin survived.
The lower eyelid is prone to eversion and retraction after burn.
Dr. Chen Hongzhang said that ectropion and adduction of lower eyelid often occur in complications after lower eyelid surgery, scar contracture after trauma (burns, facial skin and eyelid laceration), and skin tissue defect after resection of tumors around eyelid. The common reconstruction method is to release scar contracture, remove all scars that cause ectropion or adduction of the lower eyelid, and then restore the lower eyelid to its normal position according to the degree of ectropion and adduction, combined with extraocular canthus traction, skin grafting, flap surgery, eyelid spacer placement, orbicularis oculi muscle fat traction and midface lifting.
In fact, patients with ectropion and adduction of lower eyelids do not need to endure eye discomfort and continue to live with a sad look. It is suggested that if patients have suspected ectropion and adduction of eyelids, it is best to seek the evaluation of professional plastic surgeons, who will provide the most suitable surgical treatment according to the different conditions of each patient, so that patients can bid farewell to sad eyes!