Improving methods of one-stage reconstructive surgery for cicatricial eyelid defects

The purpose of the study is to analyze the processes of postoperative engraftment of various variants of a complex flap with a single-stage reconstructive blepharoplasty of perforating cicatricial eyelid defects. Material and Methods. The patients (40 eyes) who underwent a one-stage plastic reconstruction of cicatricial eyelid defects were divided into 2 groups depending on the variant of complex autograft: 20 patients 20 eyes with a three-layer flap in the main group, 20 patients 20 eyes with a double-layer in the control group. Evaluation criteria for the results were as follows: nature of complex autograft engraftment, cytological analysis of the wound exudate, clinical characteristics of the scar, size of the palpebral fissure, and microcirculation indexes. Results. 3 months after surgery the reparative process in 18 (90%) patients of the main group and in 15 (75%) patients of the control group ended with normotrophic scarring; in 2 patients (10%) of the main group there was pathological scarring, deviation in the size of the palpebral fissure was -9%; in 5 (25%) patients of the control group, we observed formation of complicated scars, deviation of palpebral fissure size was -22%. Conclusion. The main advantage of three-layer reconstructive blepharoplasty is the reduction in frequency of complicated scarring by 3 times. The mathematical algorithm that has been developed objectifies and individualizes the choice of the most rational surgical technology.