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NR 4-6/2005
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Leczenie
chirurgiczne głębokich oparzeń chemicznych powiek
Surgical management of deep
chemical burns of the eyelids
Agnieszka Żurada2, Andrzej
Zieliński1
1Z Katedry i Kliniki Chirurgii Plastycznej Akademii
Medycznej w Bydgoszczy
Kierownik: dr hab. n. med. Andrzej Zieliński
2Z Kliniki Chirurgii Plastycznej Uniwersytetu
Medycznego w Łodzi
Kierownik: prof. dr hab. n. med. Julia Kruk-Jeromin |
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| Summary: |
Chemical burns of the
eyelids are common, and this may lead to ocular damage.
A direct insult of the eyes that result in permanent
damage, is rare in facial burns. The majority of the
chemical burns of eyelids are partial-thickness that
heal spontaneously in 1 week. Whereas, 10 percent are
full-thickness burns that require release of
contractures and grafts. Wound contracture can cause
ectropion of the eyelid, resulting in exposure keratitis,
conjunctivitis, corneal ulcers, perforation, and even
blindness. At our departments, thirteen patients with 28
chemical burns of eyelids of third-degree, were reviewed.
The eyelids had burns wounds with granulation and
necrotic tissue. All patients had severe cicatrical
ectropion. The eyelids were released with incisions
running along the eyelid margin, down to the orbicularis
muscle, including the distal part of the levator
palpebrae superioris muscle, when necessary. To cover
the resulting defects, we use generous full-thickness
skin grafts, if available, for both the upper and lower
eyelids. Rarely has a tarsorrhaphy been required, and
properly constructed dressing provides satisfactory
eyelid margin immobilization and conjunctival hygiene.
Eighteen full-thickness grafts in 10 patients are
reported 8 to12 weeks after grafting. In seven eyelids,
3 patients developed ectropion and required
reconstruction of the eyelids. Our series demonstrates
that the early grafting of eyelid burns with
full-thickness grafts, can prevent the development of
recurrent cicatrical ectropion. Split-thickness grafting
should be limited to cases where we can not find the
hairless donor site for full-thickness skin grafts. |
| Słowa kluczowe: |
oparzenia chemiczne
powiek, leczenie chirurgiczne, wolne przeszczepy skóry. |
| Key words: |
chemical eyelid burns,
surgical management, free skin grafts. |
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