Early release of third-degree eyelid burns prevents eye injury

Burns to the eyelids occur in more than 20 percent of flame injuries and ca n lead to ocular damage and even blindness. Burn wound contracture can caus e ectropion of the eyelid, resulting in exposure keratitis, corneal ulcers, and conjunctivitis. At our hospital, early eyelid release and grafting has made a significant difference in the long-term outcomes of third-degree ey elid burns; however, the question of just how early eyelid release and graf ting should take place is an unresolved issue. Fifty-seven children with th ird-degree eyelid bunts were reviewed; 17 had eyelid release within 7 days of receiving eyelid burns and 40 had a delay in eyelid release of more than 17 days after injury. Analysis was by chi-square with the Yates continuity correction or Fisher's exact test when appropriate. Corneal ulcers developed in 2 of 17 of the early eyelid release of third-de gree burns, compared with 25 of 40 delayed releases (p = 0.001), exposure k eratitis in 3 of 17 early releases, and 30 of 40 in delayed release (p = 0. 000); conjunctivitis was identified in 1 of 17 early releases and 14 of 40 delayed eyelid releases (p = 0.025). Release of eyelid burns within 7 days of injury can prevent the development of exposure keratitis, progressive co njunctivitis, corneal ulceration, and the need for corneal surgery. We sugg est that early release and grafting should be the treatment of choice for c hildren and young adults with third-degree burns to the eyelids.