Introduction
While studies on wound healing exist in the published literature, research focusing on oculoplastic surgeries remains limited. This study hypothesizes that high BMIs, diabetes, and smoking, common factors associated with inflammation, will lead to unsatisfactory results in pretrichial browplasty patients. The investigation aims to identify these risk factors to enhance preoperative care and improve postoperative outcomes.
Methods
A retrospective chart review was conducted on pretrichial browplasty patients at a single academic eye center from 1999 to 2024. Data extraction utilized MiChart, supplemented by EMERSE and DataDirect. Ophthalmologic history, past medical history including diabetes status, medications, immunosuppression, smoking habits, surgery complications, and postoperative outcomes were analyzed.
Results
Among 40 patients, 42% of patients were former smokers, and 5% of patients were current smokers. Smoking pack-per-years ranged from 2 to 70 years. 50% had a BMI >30, 5% had diabetes, and 12.5% were immunosuppressed in the setting of malignancy. Infection occurred in 5% of patients, 2.5% experienced continuous postoperative bleeding, and 7.5% experienced an unsatisfactory cosmetic outcome. All of these patients were current or former smokers and had a BMI >30. Multiple visits were required in 20% of patients, and of these, 80% underwent revision procedures.
Conclusions
This preliminary study suggests specific medical states may have an impact on wound healing in oculofacial plastic surgery. While additional work is ongoing, the authors suggest that early recognition of these medical factors is crucial for tailored surgical interventions, potentially reducing postoperative complications and enhancing patient outcomes.
References
Rana HS, Clabeaux CE, Patadia AH, Allen RC. The Overweight and Obese Patient in Oculofacial Plastic Surgery: A Narrative Review. Ophthalmic Plast Reconstr Surg. 2023;39(6):525-532. doi:10.1097/IOP.0000000000002389
Bukowiecki A, Hos D, Cursiefen C, Eming SA. Wound-Healing Studies in Cornea and Skin: Parallels, Differences and Opportunities. Int J Mol Sci. 2017;18(6):1257. Published 2017 Jun 12. doi:10.3390/ijms18061257
David G Armstrong, Lawrence A Lavery, Lawrence B Harkless; Validation of a Diabetic Wound Classification System: The contribution of depth, infection, and ischemia to risk of amputation. Diabetes Care 1 May 1998; 21 (5): 855–859. https://doi.org/10.2337/diacare.21.5.855
Guarro G, Cozzani F, Rossini M, Bonati E, Del Rio P. The modified TIME-H scoring system, a versatile tool in wound management practice: a preliminary report. Acta Biomed. 2021;92(4):e2021226. Published 2021 Sep 2. doi:10.23750/abm.v92i4.10666
Masson-Meyers DS, Andrade TAM, Caetano GF, et al. Experimental models and methods for cutaneous wound healing assessment. Int J Exp Pathol. 2020;101(1-2):21-37. doi:10.1111/iep.12346
Salazar JJ, Ennis WJ, Koh TJ. Diabetes medications: Impact on inflammation and wound healing. J Diabetes Complications. 2016;30(4):746-752. doi:10.1016/j.jdiacomp.2015.12.017