Published online Jul 18, 2022. doi: 10.5500/wjt.v12.i7.175
Peer-review started: December 29, 2021
First decision: April 19, 2022
Revised: April 20, 2022
Accepted: June 18, 2022
Article in press: June 18, 2022
Published online: July 18, 2022
Reconstructive surgery of the eyelid after tumor excision, trauma or other causes can be challenging, especially due to the complexities of the anatomic structures and to the necessity of both functional and aesthetic successful outcomes. The aim of this minireview was to investigate the use of tissue transplantation in eyelid reconstruction. Surgical procedures are various, based on the use of both flaps, pedicled or free, and grafts, in order to guarantee adequate tissue reconstruction and blood supply, which are necessary for correct healing. Common techniques normally include the use of local tissues, combining non-vascularized grafts with a vascularized flap for the two lamellae repair, to attempt a reconstruction similar to the original anatomy. When defects are too wide, vast, deep, and complex or when no adjacent healthy tissues are available, distant area tissues need to be recruited as free flaps or grafts and paired with mucosal layer reconstruction. With regards to the anterior lamella, full thickness skin grafts are commonly preferred. With regards to the reconstruction of posterior lamella, there are different graft options, which include conjunctival or tarsoconjunctival, mucosal or palatal or cartilaginous grafts usually combined with local flaps. Free flap transplantation, normally reserved for rare select cases, include the use of the radial forearm and anterolateral flaps combined with mucosal grafts, which are surgical options currently reported in the literature.
Core Tip: Transplantation tends to be a viable option in eyelid reconstruction surgery. The most commonly used technique involves the use of grafts for the reconstruction of one or both eyelid structures. The use of free flaps are seldom used and are reserved for cases of extensive tissue lost. In these cases, favorable flaps considered are those that are anatomically thin and pliable.