34th Annual Scientific Meeting proceedings

Introduction: The recommended technique for repair of upper eyelid lacerations is two layers of absorbable sutures, in the upper palpebral conjunctiva and the palpebral skin.  However, the wound is at risk of dehiscence due to vascular injury.  The objective of this study is to describe repair of upper eyelid lacerations using a ‘sliding skin flap’ after dehiscence has occurred.

Materials and methods: Two cases are described.  Both cases had an initial two-layer closure that dehisced and subsequent sliding skin flap repair. 

Under general anesthesia the margins of the laceration were debrided, and the upper palpebral conjunctiva re- apposed.  A sliding skin flap was created starting from the proximal aspect of wound.  Two parallel vertical incisions were made, the distance between them was 2mm wider than the laceration.  The vertical incisions extended caudally and were 1.5x longer than the wound.  `Burow triangles` at the caudal aspect of the incisions prevented skin fold formation.  The flap was undermined, advanced to the eyelid margin and secured with interrupted sutures in 2-0 polydioxanone.  A temporary tarsorrhaphy was performed.  Both horses had adhesive dressings applied and a protective eye mask post-operatively. The tarsorrhaphy was removed after five days, and the skin sutures sequentially, ten and twelve days post operatively.

Results: Both horses recovered with good cosmesis and function.

Conclusion/Discussion: The ‘sliding skin flap’ is a simple technique that has been described for eyelid reconstruction following tumor removal.  This report suggests the technique can be modified to repair upper eyelid lacerations and when dehiscence has occurred.