THE ROLE OF 2ND-INTENTION HEALING IN PERIOCULAR RECONSTRUCTION

Second-intention healing is a time-honored method of wound management. Its role in periocular reconstruction, however, is currently controve rsial. The objectives of this thesis are threefold: to evaluate carefu lly the outcomes in a cohort of patients heated by this technique, to provide a comprehensive review of published reports, and to formulate recommendations and guidelines for appropriate application in selected patients. Eyelid and periorbital defects after excision of periocular tumors were allowed to heal by second intention in 59 patients. The l ocations of the wounds were the medial canthus (n = 32), lower eyelid (n = 20), upper eyelid, (n = 4), glabella (n = 2), and nasojugal fold (n = 1). Five excised areas involved the eyelid margin, and in three p atients the defect included the canalicular system. The size of the de fects ranged from 3 x 3 mm to 22 x 27 mm. The average duration of foll ow-up was 19 months (range, 6 months to 8 years). The functional and c osmetic results were satisfactory in 49 patients (83%). Complications occurred in 10 patients and included echopion, medial canthal webbing, trichiasis, eyelid notching, and hypertrophic scarring. Only two pati ents, however, required secondary repair. Healing by second intention is a safe, effective, and inexpensive alternative to surgical reconstr uction after tumor excision in selected patients.