Title : Scars that pull ! A post burn case of Cicatricial Ectropion
Abstract:
This presentation addresses the management of cicatricial ectropion, a condition caused by excessive scarring secondary to trauma, thermal, or chemical burns etc. The primary treatment approach discussed involves identifying and releasing cicatricial forces and harvesting full-thickness skin grafts (F.T.S.G) from two different donor sites, as opposed to a single donor site.
We present a case study of a 33-year-old female who suffered an accidental thermal burn on her face. She presented to the Ophthalmology OPD service three months later with an inability to close her right eye, pain, and blurred vision. After detailed ocular examination, she was treated for exposure keratopathy in the right eye with topical antibiotics and copious lubrication. After understanding patient’s expectation, the surgical intervention for grade 4 globe lid apposition in the right eye was performed in two staged fashion: Upper lid ectropion correction followed by lower lid ectropion correction few weeks apart.
The first stage involved releasing the upper lid scar, excising fibrotic tissue, and harvesting grafts from the two donor sites-pre-auricular and inner brachial areas. Six weeks later, the second stage was performed on the lower lid, with graft harvested from the retro-auricular area. Post-operative results showed acceptable functional and cosmetic outcomes of Right eye lid, thereby preventing serious vision threatening complications. Various literature supports this argument.
Key Takeaways:
- Using two donor sites over single donor site for graft harvesting enhances graft availability, reduces donor site morbidity, and improves aesthetic outcomes.
- A two-staged procedure allows for better wound healing.
