Management
A 68-year-old patient with multiple comorbidities underwent orbital exenteration followed by reconstruction using a bilaminate dermal substitute, which integrated acceptably and supported subsequent split thickness skin grafting [PMID:36044307].
In a retrospective study of 14 patients undergoing orbital exenteration for malignancy, the use of meshed acellular dermal allograft (SureDerm Meshed, AlloDerm Meshed, CGDerm Meshed) resulted in full or nearly full epithelialization in 71.4% at 1 month and 75.0% at 3 months post-surgery [PMID:31809482].
Complications
The use of this dermal substitute avoided major surgery in a patient with a significant risk of complications due to medical fragility and prior radiation therapy [PMID:36044307].
Delayed epithelialization occurred in 3 patients due to factors including poor wound care, adjuvant radiotherapy, and adjuvant radiotherapy followed by cerebrospinal fluid leak [PMID:31809482].
Prognosis & Follow-up
This case suggests that opting for less invasive methods like bilaminate dermal substitutes can enhance patient outcomes and manage the risk of cancer recurrence effectively [PMID:36044307].
Patients in the study had a mean follow-up period of 12.1 months, demonstrating successful epithelialization outcomes in the majority of cases [PMID:31809482].
References
1 Bothwick V, Polanik M, Lujan-Hernandez J, Akyurek M. Orbital Exenteration Reconstruction for Medically Complex Patients: Bilaminate Dermal Substitute as an Alternative to Major Surgery. The Journal of craniofacial surgery 2023. link 2 Young SM, Park JW, Kim YD, Woo KI. Use of Meshed Acellular Dermal Allograft as a Lining Material After Orbital Exenteration. Ophthalmic plastic and reconstructive surgery 2020. link
2 papers cited of 3 indexed.