Medial Canthal Defect Reconstruction Using Rotational and Glabellar Flaps скачать в хорошем качестве

Medial Canthal Defect Reconstruction Using Rotational and Glabellar Flaps

Reconstruction of the medial canthal area remains challenging owing to its concave contour and convergence of skin units with variable thickness, texture, and mobility. This procedure video illustrates a technique that uses a combination of glabellar and lateral rotational flaps for reconstruction of a deep, medial canthal defect that straddled the medial canthal tendon following excision of a basal cell carcinoma. Steps are: Lacrimal system repair with intubation using Crawford stents (00:20) Recreation of medial canthal angle by engaging the periosteum of the posterior lacrimal crest with a 4-0 polyglactin 910 suture on a P-2 needle followed by the medial portion of the eyelid defect (00:30) Design of glabellar and lateral rotational flaps were designed, with transposition to cover the superior portion of the defect. (01:32) Medial rotation of the flap to cover the inferior portion of the defect (01:47) Fixation of posterior surfaces of both flaps deep to periosteal attachments to relieve tension from the skin edges with 5-0 polyglactin 910 suture, with closure of skin incisions with 5-0 and 6-0 polypropylene and 5-0 fast-absorbing gut suture (02:16) For complete technique details and a report of patient outcomes, see http://ja.ma/2aZmaki. This video depicts a medical procedure and is intended for use by medical professionals.