Repair of full-thickness lower eyelid laceration
This is Richard Allen at the University of Iowa. This video demonstrates repair of a full-thickness lower lid laceration.
A 5-0 Vicryl suture is placed partial thickness through the anterior surface of the tarsus.
This suture is then placed on the other side of the laceration in the exact same position and depth.
A second suture is placed in a similar fashion inferiorly.
The first suture is left untied for ease of placement of the second suture.
The inferior suture is then tied to reappose the tarsus.
The superior suture is also tied which results in reapproximation of the lid margin in the correct anatomical position.
A 7-0 Vicryl suture is then placed in a vertical mattress fashion at the meibomian gland orifices.
This is placed far – far, then near – near; tying the suture results in eversion of the lid margin.
A second 7-0 Vicryl suture is placed in a similar fashion at the level of the lash follicles. This provides additional eversion of the lid margin.
The skin can then be closed with interrupted 7-0 vicryl sutures placed in a simple or vertical mattress fashion.
At the conclusion of the case, the lashes are removed from under any sutures.
Antibiotic ointment is placed over the repair and the patient returns in approximately one week for reevaluation.