V to Y island flap for repair of a medial canthal defect скачать в хорошем качестве

V to Y island flap for repair of a medial canthal defect

There are many ways to repair medial canthal defects. To me, it depends on the size, depth, and location of the defect. For relatively shallow defects, granulation is always a possibility. In this case, a V to Y island flap is performed. This has been described by JD Perry and Cathy Hwang. I’ve been pleasantly surprised by my results with this procedure for relatively small, deep defects that straddle the upper and lower eyelid. A written transcript of this video is as follows: This is Richard Allen at oculosurg.com. This video demonstrates the use of a V to Y island flap at the medial canthus. Inspection shows the location and depth of the defect with the planned V to Y. This is a relatively deep defect and the upper and lower canaliculus have been violated, which is addressed with a bicanalicular stent. The 15 blade is used to make an incision along the V. The angular artery and vein do run in this area, and it is good to be cognizant of their location and depth to avoid them. The needle tip cautery is then used to raise the flap and maintain the connection posteriorly. Again, bleeding may occur and cautery usually will be needed. The medial dissection of the island flap should be deep, while the lateral dissection of the flap should be more superficial. The defect is then widely undermined. The mobilization of the flap is demonstrated. Closing the donor site, usually aids in transposition of the flap. This is performed with deep interrupted 5-0 Vicryl suture. The medial canthal tendon is then engaged with the second suture to aid in the formation of a concave contour. The flap is positioned and sutured superficially with 5-0 fast absorbing sutures. Superficial 5-0 fast absorbing sutures are then placed in the area of the donor site. At the conclusion of the case, antibiotic ointment will be placed over the repair and a pressure patch will be placed for one day. The patient will follow up in approximately one week. Over 400 oculoplastic surgery videos are available, free of charge, here on YouTube and at http://www.oculosurg.com