Modified Hughes flap - division at 7 days

Abstract

<h4>Purpose</h4>To report the outcome of early division of the tarsoconjunctival pedicle of a modified Hughes flap at 1 week after the primary operation.<h4>Design</h4>Noncomparative, interventional, prospective case series.<h4>Participants</h4>Twenty-nine eyelids of 29 consecutive patients operated using the modified Hughes flap and full-thickness skin graft for lower eyelid reconstruction after Mohs micrographic surgery, over a 4-year period.<h4>Intervention</h4>In all patients, the pedicle of the Hughes flap was divided 1 week after the primary operation.<h4>Main outcome measures</h4>Postoperative lower eyelid flap viability and lower eyelid contour complications.<h4>Results</h4>Twenty-nine eyelids of 29 patients (mean age: 69+/-11 years) were operated using the modified Hughes flap. The mean follow-up period was 14+/-6 months (range: 6-23). There were no cases of lower eyelid retraction, flap ischemia, or necrosis after division. Postoperative complications included lower eyelid margin erythema in 2 patients (6.9%), upper eyelid lash ptosis in 3 patients (10.3%), and upper eyelid lateral retraction in 1 patient (3.4%).<h4>Conclusion</h4>Early division of the tarsoconjunctival pedicle of a modified Hughes flap at 1 week does not compromise the viability of the reconstructed lower eyelid and results in a good functional and cosmetic outcome.