VERTICAL AND HORIZONTAL TRACTION SUTURES IN LID SURGERY

Background Patients with lid surgery may benefit from traction sutures . However no detailed descriptions of the techniques exists. We descri be our techniques and experiences in patients with cicatricial ectropi on and large lid defects. Patients and Methods In 33 patients with sev ere cicatricial ectropion, the wound was extended with transtarsal tra ction sutures before skin grafts or sliding flaps were sutured in plac e. Horizontal traction sutures allowed wound closure in 7 patients wit h tumors of the medial canthal area or large traumatic lid defects. In all patients monofil 4-0 polypropylene suture material was used. Resu lts Vertical transtarsal traction sutures and horizontal traction sutu res did not cause any irritations of the lids or wound edges. Postoper ative overcorrection of the lower lid margin was achieved in all ectro pion patients. However, five patients required additional surgery. Thr ee patients were operated for bilateral cicatricial ectropion simultan ously. Postoperative shrinkage of the free skin-graft was more acceler ated on the side where the transtarsal traction sutures were first rem oved. Horizontal traction sutures allowed wound closure in all seven p atients who had undergone medial canthal reconstruction and traumatic lid repair. Conclusion Traction sutures with monofil 4-0 polypropylen material can fixate the lidmargins and wound edges in the preoperative ly desired position. There is evidence that the traction sutures can i nfluence postoperative wound contraction. Our technique of transtarsal traction sutures has several advantages as compared with previously d escribed techniques.