Simple lacrimal duct rupture suture

The lacrimal canal rupture caused by trauma of the internal malleolus can be repaired by sutureless suture. However, fresh fractures and old fracture repair suture methods are different. Treating diseases: eye diseases Indication A recent tear in the tubule caused by trauma to the internal iliac crest. Preoperative preparation Prepare an epidural catheter. Surgical procedure 1. Clean the wound, check the degree of trauma, and estimate the location of the broken tubule. 2. Expand the punctum, insert a tear duct into the punctum, rinse the needle, and find the sacral end of the lacrimal canal. 3. It is difficult to find the nasal end of the lacrimal canal. If you can find (such as a white tube) you can suture. 4. Leave the irrigation needle as a support in the canaliculus and stick it to the eyebrow. 5. If you can't find the nasal side of the lacrimal canal, you can find it by following the steps below. The skin was removed by reference to the method of removing the lacrimal sac, and the orbicularis muscle was separated, and the lacrimal sac was cut along the long axis of the lacrimal sac. Pull the side of the lacrimal sac incision and find the inner mouth of the tear duct. 6. Use a No. 4 lacrimal passage to flush the needle from the inner mouth of the tear duct and lead to the end of the lacrimal canal. 7. After the rinsing needle is exposed, it is held by the assistant to prevent it from coming out. Instead of rinsing the needle with an epidural catheter, the punctum is inserted and the mouth is exposed. 8. The metal core of the epidural catheter is sent to the lacrimal passage irrigation needle, and the epidural catheter is inserted into the nasal side of the canaliculus under the guidance of the irrigation needle. 9. After the epidural catheter enters the lacrimal sac, the metal core is removed. The nasolacrimal duct was fed with the help of a vascular clamp, and the tissue around the broken end of the two tear ducts was sutured with a 6-0 nylon thread, and the muscle skin was sutured. 10. Suture the lacrimal sac and the orbicularis oculi muscle with 5-0 silk or nylon thread. The skin is sewn 3 to 5 needles. The epidural catheter in the canaliculus is attached to the eyebrow with a tape or the ends are tied together. Single eye pad plus light pressure bandage. complication The main complication is re-occlusion and reoperation.