University of Iowa Health Care

Ophthalmology and Visual Sciences

Full-thickness skin graft for lateral lower eyelid defect

Richard C. Allen, MD, PhD, FACS

Additional Notes: Length 02:04

Posted Feb 10, 2017

This is Richard Allen at the University of Iowa. This video demonstrates placement of a full-thickness skin graft for a Mohs defect of the lateral lower eyelid. The defect is inspected and a piece of Telfa is placed over the defect in order to make a template of the defect. The size of the template is inspected and appears adequate. This will then be transferred to the donor site which, in this case, is the retroauricular area. The graft is harvested and placed into position. The graft is then sutured into position with interrupted 5-0 fast-absorbing suture. One could have attempted a lateral rotational flap in this patient however due to the tightness of the skin was determined that a skin graft would work best for him. Additional 5–0 fast-absorbing sutures are placed. Once the graft is in good position, a bolster will be placed over it. This will be placed with 6-0 silk sutures which are placed around the repair. The sutures are cut long. The Telfa is then placed over the defect which has been coated with antibiotic ointment. A bolster from a scrub sponge is then fixated over the Telfa with the 6–0 silk sutures. A double eye pad will be placed to provide additional pressure on the graft. The patient will return 1 week for removal of the patch in the sutures.

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last updated: 02/22/2017
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