Reconstruction of Skin Defects in the Medial Canthal Region Using the Novel Hug Flap.

Various methods of reconstructing skin defects in the medial canthal region have been reported. We report 2 skin flaps for the upper and lower eyelids designed to reconstruct soft tissue defects in the medial canthal region based on the approach used for the orbit during surgeries for facial bone fractures. The skin flap was elevated without tension until it reached the defect. The skin flaps of the upper and lower eyelids were moved around the defect as rotational flaps and sutured. Two patients with skin defects in the medial canthal region after basal cell carcinoma resection were treated with this technique. No complications occurred, and good cosmetic and functional outcomes were obtained. This method can be used to reconstruct the eyelid with an elevated skin flap and is considered useful for repairing defects in the medial canthal region.

Selection of Artificial Dermis for Shortening Treatment Period: Integra versus Pelnac.

Skin reconstruction of full-thickness skin defect wounds using artificial dermis is performed using secondary split-thickness skin grafting. For the selection of artificial dermis to shorten the treatment period, the waiting time until secondary skin grafting was investigated when the dermis-like tissue was constructed with Pelnac or Integra. METHODS: We evaluated 26 patients who underwent secondary skin grafting after dermis reconstruction with Pelnac (18 patients) or Integra (8 patients) for full-thickness skin defects between 2006 and 2017. The waiting period from artificial dermis application to closure of the full-thickness skin defect with a secondary skin graft was investigated retrospectively. RESULTS: Skin grafts survived well in all cases, and no complications of grafts or donors were observed. The mean waiting period was 17.5 ± 4.2 and 22.0 ± 4.6 days for the Pelnac and Integra groups, respectively (significantly shorter in the Pelnac group). CONCLUSIONS: The difference in waiting period is presumed to be due to the structural differences between the collagen sponge layer, which is the dermal replacement layer of Pelnac and Integra grafts. In cases where shortening the treatment period is important, Pelnac should be the first choice. In addition, in pediatric cases and widespread burns where it is difficult to control the infection during the waiting period, Pelnac is considered to be the first choice because the risk can be reduced by shortening the waiting period.