xRead - Facial Reconstruction Following Mohs Micrographic Surgery

Archives of Dermatological Research (2023) 315:1853–1861

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Table 2 Complications for repair techniques utilized for lower eyelid defects and medial canthus defects Complications for lower eyelid defects Article No. patients Repair type

Complications No. of patients (% of patients)

Leibovitch [16]

111

FTSG

Partial graft failure 4 (4%) Graft hypertrophy 2 (2%) Graft contracture 2 (2%) Graft contracture + ectropion 2 (2%)

Trapdoor 1 (< 1%) Infection 1 (< 1%) Hematoma 1 (<1%)

DeSousa [42] DeSousa [42] Custer [21]

9 3

Sliding tarsal flap + FTSG

Mild eyelid retraction 2 (22%)

Sliding tarsal flap + Advancement flap

Entropion 1 (33%)

Misdirected eyelashes 5 (16%) Mild erythema of eyelid margin 3 (9%) Pyogenic granuloma 1 (3%)

32

Sliding tarsal flap + Rhombic flap (24 patients) Sliding tarsal flap + Rhombic flap + FTSG (4 patients) Sliding tarsal flap + FTSG (4 patients) Periosteal strip ± Free tarsal graft from contralateral upper lid if periosteal strip had insufficient reach + Advancement flap; used for lateral lower eyelid defects Medial advancement of the lateral posterior lamella + Peri osteal strip + Advancement flap; used central or medial lower eyelid defects

None

Perry [39]

9

Misdirected eyelashes 2 (7%) Ectropion 3 (10%) Granuloma 1 (3%)

Perry [39]

29

Hypertrophic scar 1 (3%) Segmental trichiasis 1 (3%) Symblepharon 1 (3%) Epiphora 1 (3%) Kink of free tarsal graft donor site 1 (3%)

Lewin [17] Lin [47] Kim [43] Almeida [49] Almeida [49]

8

Inferiorly based rotation flap

None None

10

Spiral rotation flap Pedicled propeller flap

5 4 1 3 6

Pincushioning 1 (20%)

McGregor flap

None

McGregor flap + Matsuo’s technique with cartilage graft Tunneled pedicle flap based on angular artery Transconjunctival lateral cantholysis + Full-thickness lid advancement

Ectropion 1 (100%)

Seo [2]

None None

Lewis [46]

Leibovitch [24] Leibovitch [24]

11 18

Hughes transconjunctival flap

None

Hughes transconjunctival flap + FTSG

Mild eyelash ptosis 3 (17%) Eyelid margin erythema 2 (11%) Upper eyelid retraction 1 (6%)

Choi [9]

2

Paramedian/median forehead flap

None

Complications for medial canthus defects Leibovitch [16] 264 FTSG

Graft hypertrophy 26 (10%) Trapdoor 6 (2%) Partial graft failure 4 (2%) Infection 3 (1%) Web contracture 2 (< 1%) Hematoma 2 (< 1%) Graft contraction 2 (< 1%) Graft contraction + ectropion 2 (< 1%) Complete graft failure 1 (< 1%)

Seo [2]

3

Island pedicle flap

Flap bulkiness 1 (33%)

Mild punctual eversion 1 (9%)

Stewart [36]

11

Island pedicle flap (10 patients) Island pedicle flap + FTSG for pre-existing ectropion (1 patient)

Skaria [52] Skaria [52] Cecchi [19]

12

Island pedicle flap, single Island pedicle flap, double

None

4 8

Mild webbing 1 (25%)

Island pedicle flap

None

1 3