Treatment of cicatricial eyelid ectropion: experience with the use of full thickness skin graft at Jos

Abstract

Introduction: Cicatricial ectropion usually occurs following the healing of eyelid wounds from burn injury, other traumas and infections. Most reports are on treatment of lower eyelid ectropion where local flaps are
commonly used for reconstruction. In the absence of such flaps, full thickness skin grafts can be used. We present our experience with the use of full thickness graft.
Patients and Methods: Patients who had eyelid reconstruction for ectropion between January 2000 and December 2006 at the Jos University Teaching Hospital were reviewed. The information obtained from the operation register as well as the patients’ case notes included demographic data, working diagnosis, aetiology, affected eyelid(s), the type of surgery and associated medical condition.
Results: A total of 18 patients were seen, nine males and nine females. Their ages ranged from 1 to 52 years (mean= 20.5 ± 14.3 years). The causes of the ectropion were flame burn in 11 (61.1%), road traffic
accident (RTA) in 4 (22.2%), acid burn, herpes zoster and drug reaction in one (5.5%) each. The duration of the development of ectropion and surgery was one month to four years (mean = 0.83 ± 1.2 years). The
affected eyelids were upper in twelve (66.6%) patients, lower in 3 (16.7%) and both upper and lower eyelids in 3 (16.7%). The left side was the more affected with 10 (55.5%) patients, the right and bilateral with four
(22.2%) patients each. Full thickness skin graft was used in all the reconstructions. One of the patients had a previous reconstruction with split thickness graft. The outcome of the procedure was both functionally and
aesthetically good.
Conclusion: Full thickness graft from the posterior auricular area provides good functional and aesthetic result in the reconstruction of cicatricial eyelid ectropion.

Key words: Ectropion, Eyelid, Cicatricial, Full thickness skin graft