Dependence of the Results of Free Skin Transplantation on the Donor Site in Case of Eyelid Defects Central Research Institute of Dental and Maxillofacial Surgery, Moscow PhD Marina B Gushchina Objective To analyze the pre-op and post-op changes of dimensions, thickness and elasticity of free skin fullthickness grafts from the upper eyelid and retroauricular region and donor site morbidity Method An analysis was conducted of 57 patients with full-thickness free autodermal grafts from the upper eyelid and the retroauricular region to the eyelids defects The age of patients was from 3 to 67 years old 1st group 47 full-thickness free autodermal grafts from the upper eyelid average age was (37,08±17,67) 2nd group 10 full-thickness free autodermal grafts from the retroauricular region (average age was 36,5±21,17) Results were analyzed 1 year after surgery Method Autodermotransplantation has been performed senior author technique using compression plates (CP) for fixing of free skin grafts Manufacturer: Reper-NN (Russian Federation, Nizhny Novgorod city) Method The size of the defects and the grafts was measured using millimeter paper Method The skin thickness in the recipient and donor areas was measured using ultrasound Ultrasonic sensor 22 MHz Skin elasticity was determined in conventional units (CU) by a method based on skin penetration per unit time Method Multi Skin Test Center MC 1000 Upper eyelid (right) 68 Upper eyelid (left ) 52 Retroauricular region 59 Results In case of skin defects from 321 to 840 mm2 (459.72±84.85) free grafts from the upper eyelid were used (1st group) Results In case, when defects from 698 to 1542 mm2 (1285,4±308,48) were used grafts from the retroauricular region (2nd group) Results Postoperative scars in donor site were thin, soft and located in natural skin folds in the both groups 1st group 2nd group Results The size of the grafts before and after autodermotransplantation Size of the grafts (mm2) Donor side Before After Δ Upper eyelid (gr. 1) 459.72±84.85 307.4±66.31 152,3 (33.1%) Retroauricular region (gr. 2) 1285,4±308,48 621.2±127.62 664,2(51.67%) Smaller skin grafts were used in the first group because the excess of skin on the upper eyelid is less than behind the ear After autotransplantation, free skin grafts were reduced by one third in the first group and more than half in the second group Results The thickness of the skin grafts before and after autodermotransplantation Thickness of the skin graft (mm) Donor side Upper eyelid (gr. 1) Retroauricular region (gr. 2) Before After Δ 1,145±0.15 1.46±0.06 0,315 (27,5%) 1.1±0.25 2.25± 0.06 1,150(204,5%) Ultrasound measurements of skin thickness in vivo showed that the skin before transplantation was almost the same in both groups However, after autotransplantation, free full-thickness grafts from the upper eyelid changed less and were thinner than from the retroauricular region Results 1st group 2nd group Before autotransplantation After autotransplantation Results The elasticity of the skin grafts before and after autodermotransplantation Elasticity of the skin graft (CU) Donor side Upper eyelid (gr. 1) Retroauricular region (gr. 2) Before After Δ 68±1,16 59.09 ± 2.82 9 (13.10%) 58.7 ± 1,42 51.7±1.16 7 (11.93% ) Before autotransplantation the skin was more elastic in the upper eyelid than in the retroauricular region After autotransplantation, the elasticity of free skin grafts became less in both groups However, the free skin grafts in the first group after autotransplantation was more elastic Results Clinical cases 1st group 2nd group Clinical cases 1st group Results 2nd group Conclusion Excess skin of the upper eyelid and in retroauricular region can be used for autodermatoplasty without compromising the donor site The retroauricular region allows to obtain large grafts The initial state of the donor sites skin in both groups did not differ in thickness, but differed in elasticity After transplantation, the graft in both groups were reduced in size and had no permanent thickness In this case, the skin from the retroauricular region was more prone to contraction, more thicker and with low elasticity FINANCIAL DISCLOSURE. No. Thank you for your attention
