Full-thickness grafting of acute eyelid burns should not be considered taboo

Split-thickness skill grafts are commonly used for the treatment of acute e yelid burns; in fact, this is dogma for the upper lid. Ectropion, corneal e xposure, and repeated grafting are common sequelae, almost the rule. It was hypothesized that for acute eyelid bunts, the use of full-thickness skin g rafts, which contract less than split-thickness skin grafts, would result i n a lower incidence of ectropion with less corneal exposure and fewer recur rences. The records of all patients (n = 18) who underwent primary skin gra fting of acutely burned eyelids(n = 50) between 1985 and 1995 were analyzed retrospectively. There were 10 patients who received full-thickness skin g rafts (12 upper lids, 8 lower lids) and 8 patients who received split-thick ness skin grafts (15 upper lids, 15 lower lids). Three of 10 patients (30 p ercent) who received full-thickness skin grafts and 7 of 8 patients (88 per cent) who received split-thickness skin grafts developed ectropion and requ ired reconstruction of the lids (p = 0.02). No articles were found substant iating the concept that only split-thickness grafts be used for acute eyeli d burns. The treatment of acute eyelid burns with full-thickness rather tha n split-thickness skin grafts results in less ectropion and fewer reconstru ctive procedures. It should no longer be considered taboo and should be car ried out whenever possible and appropriate.