Microvascular Free Transfer of A First Web Space Skin Flap of The Foot to Reconstruct The Upper and Lower Eyelids



Microvascular Free Transfer of A First Web Space Skin Flap of The Foot to Reconstruct The Upper and Lower Eyelids


L. A. CHAIT



The reconstruction of both upper and lower eyelids when their total loss accompanies orbital exenteration is difficult (1, 2). This deformity may result from tumor excision or trauma. For this reason, the use of a prosthesis that is either applied directly over the cavity or attached to spectacles is often advised. However, patients sometimes request reconstruction (Fig. 33.1).




ANATOMY

See Chapter 335.


FLAP DESIGN AND DIMENSIONS

The flap includes the skin of the first web space of the foot, with extensions running onto adjacent toes as far as their tips. Enough skin must be removed from each toe to allow it to be folded on itself to provide both lid cover and lining. A small area of dorsal foot skin proximal to the web is included (Fig. 33.2). The flap must be taken from the foot on
the ipsilateral side, because the web has to provide the lateral canthus and the dorsal skin must be external.






FIGURE 33.1 A,B: Patient 10 years after orbital exenteration for rhabdomyosarcoma. Socket was lined with a split-thickness skin graft.

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Jun 26, 2016 | Posted by in General Surgery | Comments Off on Microvascular Free Transfer of A First Web Space Skin Flap of The Foot to Reconstruct The Upper and Lower Eyelids

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