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Title Use of penile full thickness skin grafts in complex eyelid burns reconstructions to avoid sight threatening corneal exposure
Submitted by Adriana Chilinska
Abstract Number 375
Review Result poster presentation
Purpose

to present the value of foreskin graft as a donor site for a repair of upper and lower lids in men sustained severe burns

Methods

we present series of 5 cases of foreskin grafts to manage severe thermal burns to upper and lower eyelids in men aged 21-50 years, treated in Royal Victoria Infirmary between 2013-2018 in close cooperation between Oculoplastic and Plastic Surgery teams. Circumcision was performed by plastic surgeon, graft was placed on eyelids by oculoplastic surgeon using a fibrin sealant. Surgery was unilateral in one case, bilateral in four cases.
All of our patients sustained major burns involving facial area with 8-80 % of total body surface burn. 1 patient sustained severe chemical burns to corneas, one eye had to be enucleated.

Results

Good graft take was achieved in 4 patients, failed in 1 as tarsoraphy was open too early. Good cornea protection was provided. The colour match of skin graft was satisfying. There was no donor site morbidity. Photographs will be presented.

Conclusion

The common donor sites are rarely accessible in severe burns. Prepuce skin is an ideal material for eyelids burn contracture due to high content of elastic fibres and a low content of smooth muscle fibre what makes it less likely to shrink as compared to any other graft sites. Prepuce skin is hairless, plentiful and easy to harvest. The disadvantage is its hyperpigmentation and low thickness that makes it more prone to laceration and infection.
The foreskin is often overlooked by surgeons as a donor options and should be considered primary treatment modality in men for eyelids reconstruction followed major facial burns providing good cornea protection.


Additional Authors

Last name Initials City / Hospital Department
Clarke LC Royal Victoria Infirmary Newcastle upon Tyne Foundation Trust Ophthalmology
Varma SV Royal Victoria Infirmary Newcastle upon Tyne Foundation Trust Plastic Surgery

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