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Orbit. 2009;28(1):12-5. doi: 10.1080/01676830802417510.

Laissez-faire: how far can you go?

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1
Maidstone Hospital, Kent, United Kingdom.

Abstract

INTRODUCTION:

Lid defects created by removal of tumors are conventionally repaired by lid reconstruction. An alternative to surgical repair is wound healing by secondary intention. This technique, laissez-faire, as used in the periorbital region, was first described in 1957.

PURPOSE:

This report considers how effective this technique is for defects of various sizes and different locations in the periorbital region.

METHODS:

Defects following excision of periocular tumors in 10 Caucasian patients were allowed to heal by laissez-faire. The locations of the defects were the medial canthus (n = 4), lower eyelid (n = 4), lateral canthus (n = 1), and upper lid (n = 1). The functional and cosmetic outcome of the healing process was noted.

RESULTS:

A good functional and cosmetic outcome were obtained after healing by laissez-faire in 8 of the 10 patients. Of the 2 remaining patients one patient had a large medial canthal and lower lid defect which extended onto the cheek, which healed with residual scarring and medial ectropion. The second patient had a lower lid defect, which healed with a cicatricial ectropion. Of the 2 patients, only one required further surgery.

CONCLUSIONS:

This report shows the technique of healing by laissez-faire can be extended for relatively large defects with good results. The medial canthal region and full-thickness lower lid defects remain the favored locations for healing by secondary intention. In large defects particularly with extension onto the cheek, there is a significant risk of cicatrization, and the possibility of a second corrective operation should be discussed with the patient prior to tumor excision.

PMID:
19229738
DOI:
10.1080/01676830802417510
[Indexed for MEDLINE]
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