Surgical treatment of severe cicatricial ectropion

Scarring orbital valgus correction surgery includes mild scarring orbital valgus surgery and severe scarring orbital valgus surgery. Treatment of diseases: senile external valgus and valgus Indication Severe valgus valgus refers to the entire eyelid flipping outward, exposing the conjunctiva and cornea, and long-term stimulation to the outside air and foreign matter, causing eye pain, conjunctival hyperemia, hypertrophy, dry and rough cornea, forming exposed keratitis. Seriously affects vision. Preoperative preparation Preoperative conjunctival sac culture and drug sensitivity test. Because this type of local anesthetic infiltration is affected by the operation and the patient feels pain, general anesthesia should be used. Preoperative attention to preparation before general anesthesia. The donor site is prepared for skin preparation. The choice of skin is mostly medium-thickness skin or full-thickness skin. A small range of full-thickness skins can be taken from the upper eyelids of the contralateral eye, or from the back of the ear, the medial side of the upper arm, and the supraclavicular region of the neck. The skin characteristics of this part are similar to those of the eyelid skin. Relatively sufficient. For a wide range of free skin grafts, the medium-thickness skin should be cut and cut with a peeling machine or a roller knife. The donor area is mostly selected from the inside of the thigh. Usually the skin area is prepared for 3 days. Surgical procedure 1. A skin incision is made from the iliac crest at a distance of 2 to 3 mm from the iliac crest. The incision at both ends of the severely ill patient should exceed the internal and external crotch. 2. If there are thick scars on both sides of the ankle, they should be removed. The scar tissue in the skin surface and deep tissue is removed, and the traction force caused by the scar tissue at the base of the wound surface is released. After the scar was released, the position of the eyelid returned to normal. 3. For the upper and lower eyelid margin suture. 4. Print the size, shape and cut into a mold with gauze or rubber sheet. According to the size of the die, a free medium-thickness skin piece or a full-thickness skin piece which is 1/4 larger than the size in the donor area is cut in order to prevent the skin piece from shrinking. The donor site of the donor site is treated as usual and compression is applied. The free skin pieces were trimmed, the adipose tissue under the free skin piece was removed, and the free skin piece was placed on the eyelid skin wound. The free skin piece and the wound edge of the skin defect wound are sutured intermittently, and 6 to 8 long-line heads corresponding to each other are left in each direction for packing and ligation. 5. Make 2 or 3 drainage incisions on the surface of the skin to clean the local blood and blood clots. The surface of the transplanted skin is covered with a layer of fine gauze dipped in a small amount of 75% alcohol or antibiotics, and the long-line head is kept for packing and ligation. Pay attention to the pressure evenly, and avoid the skin at the suture to lift the skin piece, resulting in postoperative skin piece. Uneven. The surface cover is pressure-wrapped with gauze.

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