Full-thickness skin graft to upper eyelid defect
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This is Richard Allen at the University of Iowa.
This video demonstrates the use of a full-thickness skin graft for repair of an upper eyelid anterior lamellar defect.
Examination of the defect shows evidence of remaining orbicularis muscle, indicating a relatively shallow defect. Telfa is used to make a template of the defect. The template is then used to mark and harvest a full-thickness skin graft from the retroauricular area. The graft is placed into the defect and appears to cover it well. A combination of interrupted and running 5-0 fast absorbing sutures are then used to suture the graft into position. Interrupted 5-0 fast absorbing sutures are initially placed at the cardinal positions of the graft. The repair is then completed with running 5-0 fast absorbing sutures.
6-0 silk sutures are then placed around the graft and cut long. Approximately six such sutures are placed. These sutures will fixate the bolster into position. Antibiotic ointment is placed over the graft. A bolster is fashioned from a scrub sponge and placed over the graft. The silk sutures are then tied over the bolster to place pressure on the graft. An eye pad is placed over the repair and the patient will return in one week for patch and suture removal.