Abstract：
Large congenital lid colobomas are traditionally repaired using 1- or 2-step vascularized flap-graft combinations. However, visual axis occlusion for weeks is a severe problem in small children and recent reports suggest that the flap pedicle does not contribute to blood perfusion. A \"one-step\" substitute for large lid defects has recently been reported in animals and humans, demonstrating the viability of a bilamellar autograft alone. We present an alternative \"one-step\" reconstructive approach in a 6-month-old infant who had a centrally-located large upper eyelid defect resulting from a congenital coloboma. The free full-thickness bilamellar autograft was harvested from the contralateral upper eyelid. The follow-up time was 48 months. Cosmetic and functional results were good, the bilamellar graft survived, and there was no graft ischemia, necrosis, or rejection. The boy developed madarosis, lid notching, and mild contour irregularity but needed no reoperation since the parent was satisfied with the surgical result. A free bilamellar eyelid autograft seems to be an outstanding alternative to both \"conventional 2-step\" and \"modern 1-step\" options for the reconstruction of large colobomatous eyelid openings, especially in young infants who cannot tolerate visual axis blockage. It is an easy, practical, fast, and effective technique that also saves cost in health care.
摘要：
传统上，使用1步或2步血管化皮瓣移植组合修复大的先天性眼睑瘤。然而,视觉轴阻塞数周是一个严重的问题，在小的孩子和最近的报道表明，皮瓣蒂不有助于血液灌注。最近在动物和人类中报道了一种“一步”替代大型盖子缺陷的方法，证明了单独的双层自体移植物的可行性。我们提出了一种替代的“一步”重建方法，该方法适用于6个月大的婴儿，该婴儿因先天性结肠缺损而位于中央的上眼睑缺损。从对侧上眼睑收获自由的全厚度双层自体移植物。随访时间为48个月。化妆品和功能效果良好，双层移植物存活下来,没有移植物缺血，坏死,或拒绝。这个男孩患上了马达罗病，盖子开槽,和轻微的轮廓不规则，但不需要再次手术，因为父母对手术结果感到满意。自由的双层眼睑自体移植似乎是重建大型结肠腺瘤性眼睑开口的“常规2步”和“现代1步”选项的出色替代方案，尤其是在不能耐受视轴阻塞的年轻婴儿中。这是一个简单的,实用,快,和有效的技术，也节省了医疗保健成本。
