Steroid injection to decrease contracture in a skin graft
Richard C. Allen, MD, PhD, FACS
Additional Notes: Length 01:28
Posted Feb 10, 2017
This is Richard Allen at the University of Iowa. This video demonstrates a steroid injection to the lower eyelid of a patient who had a previous full thickness skin graft for a thermal burn. The patient has had skin grafts to both lower eyelids and it has been determined that the skin graft of lower eyelid on the right has had an exuberant healing process. Therefore, a combination of triamcinolone (40mg/ml) and dexamethasone (10 mg/ml) will be injected. I like to perform this trans-conjunctivally due to the fact that it is difficult to get the steroid directly under the skin. In addition, if the injection is too superficial, it can be visible due to the vehicle of the triamcinolone. As noted here, the injection is not into the graft but under it. The patient will be instructed to perform massage along the eyelid in an upward manner for the next month. Reevaluation will be performed at a month. Potentially, an additional injection may need to be performed.
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