文献中有许多关于Mohs显微手术(MMS)或手术切除后的眶周重建的文章,然而,文献缺乏对这些报告的全面系统回顾.我们对已发表的有关眶周缺损重建的数据进行了系统的回顾,以确定文献中的趋势。对八个数据库进行了全面搜索。要纳入研究,文章必须在2005年至2020年期间以英文发表,并且包含MMS或眶周区切除缺损的修复数据.少于四名患者的研究,文献或系统综述,和抽象的出版物被排除在外。从符合条件的文章中提取的数据包括作者的医学专业,研究设计,主题数量和人口统计,缺陷特征,程序类型,重建方法,并发症,结果衡量标准,和结果评估的方法。53项研究符合纳入标准。第一位和最后一位作者的专业是眼科(47%),整形和重建手术(23%),皮肤科(13%),耳鼻喉科(4%),或者是多专业合作(13%)。只有5项研究是前瞻性的。缺陷位于下眼睑(55%),内侧can(31%),上眼睑(8%),外侧can(4%),或这些网站的组合(2%)。重建方法报告3678例,包括线性修复(18%),前进皮瓣(8%),旋转皮瓣(5%),转位皮瓣(3%),岛状蒂皮瓣(1%),不明局部皮瓣(21%),皮肤移植(23%),次要意图(4%),表结膜瓣(3%),和联合重建技术(13%)。53篇文章中有33篇为所采用的每种重建技术指定了眶周亚单位。在这33篇允许缺陷位置和重建技术之间关联的文章中,下眼睑缺损修复最常用的方法是局部皮瓣。最常使用皮肤移植物修复上眼睑或内侧can上的缺陷。40篇文章评论了美容效果,然而,这些文章中只有3篇使用了定义的评分系统,客观测量,或独立审稿人评估美容效果。这篇综述的重建方法多种多样,然而,局部皮瓣和移植物是最常用的技术。在未来的报告中,通过缺陷位置增加重建技术的报告以及更多使用美学结果的标准化评估可以帮助加强这一文献。
There are many articles in the literature on periorbital reconstruction after Mohs micrographic surgery (MMS) or surgical excision, however, the literature lacks a comprehensive systematic
review of these reports. We performed a systematic
review of published data on periorbital defect reconstruction to identify trends in the literature. A comprehensive search of eight databases was performed. To be included in the study, articles had to be published in English between 2005 and 2020 and contain repair data for MMS or excision defects in the periorbital region. Studies with less than four patients, literature or systematic reviews, and abstract-only publications were excluded. Data extracted from eligible articles included the authors\' medical specialties, study design, subject number and demographics, defect characteristics, procedure type, reconstructive methods, complications, outcome measures, and method of outcome assessment. 53 studies met the inclusion criteria. The first and last authors\' specialties were ophthalmology (47%), plastic and reconstructive surgery (23%), dermatology (13%), otolaryngology (4%), or were multi-specialty collaborations (13%). Only 5 of the studies were prospective. Defects were located on the lower eyelid (55%), medial canthus (31%), upper eyelid (8%), lateral canthus (4%), or a combination of these sites (2%). Reconstructive methods were reported for 3678 cases and included linear repair (18%), advancement flap (8%), rotation flap (5%), transposition flap (3%), island pedicle flap (1%), unspecified local skin flap (21%), skin graft (23%), secondary intention (4%), tarsoconjunctival flap (3%), and combined reconstruction techniques (13%). Thirty-three of 53 articles specified the periorbital subunit for each reconstructive technique that was employed. Among these 33 articles which allowed for correlation between defect location and reconstructive technique, the most utilized repair method for lower eyelid defects was local skin flap. Defects on the upper eyelid or medial canthus were most frequently repaired with a skin graft. Forty articles commented on cosmetic outcomes, however, only 3 of these articles utilized a defined grading system, objective measurements, or independent reviewers to assess the cosmetic outcomes. The methods of reconstruction in this
review were diverse, however, local skin flaps and grafts were the most utilized techniques. In future reports, increased reporting of reconstructive technique by defect location as well as increased use of standardized assessments of aesthetic outcomes can help strengthen this body of literature.