WARNING:
JavaScript is turned OFF. None of the links on this concept map will
work until it is reactivated.
If you need help turning JavaScript On, click here.
This Concept Map, created with IHMC CmapTools, has information related to: Techniques, Laceration Repair ANOTHER METHOD Direct reapposition is possible when one-third or less of the lid margin is absent, but more extensive injuries necessitate the use of advancement flaps or grafts for proper repair. It is essential to preserve the eyelid margin and its related structures to maintain normal eyelid function. Even thin strips of tissue created by lacerations running parallel to the eyelid margin should not be excised, as removing them may require reconstruction of the eyelid margin., Eyelid tacking for entropion Eyelid tacking Eyelid tacking is a temporary and non-surgical approach used in cattle to manage entropion, a condition where the eyelids roll inward, causing irritation to the eye. Eyelid tacking is often employed in cases where surgical correction is not immediately possible or when the condition is expected to resolve over time. In cattle can either be congenital rare; usually spastic, cicatricial and in young, dehydrated calves. Eyelid tacking procedure for entropion in cattle include temporary tacking sutures and surgical correction. Temporary tacking sutures, Employ a monofilament suture. The choice of suture size depends on the animal's size, ranging from 1-0 to 4-0. A cutting needle is necessary. ???? Proceed as follows: Direct the needle through the stem. Guide the needle full-thickness through the skin and have it emerge in the superior-lateral conjunctival fornix. Guide the needle through the outer (palpebral) conjunctival surface of the third eyelid, positioning it midway between the base of the T-cartilage and the "crossbar." Aim to engage the cartilage, but exercise caution to avoid going full-thickness through the lid to prevent ulcers. Redirect the needle through the superior-lateral fornix, exit through the skin, and secure the stent., The interior of the bony orbit serves as a reference point. The medial and lateral canthal ligaments are sharply severed to allow access to the rear portion of the orbit. It is advisable to delay the transection of the medial canthal ligaments until it becomes necessary, as there is a significant blood vessel associated with the medial canthus. ???? In most cases of eye removal, complete excision of orbital tissue is required. The retrobulbar musculature and the sheath of the optic nerve should be transected as far caudally as possible., Eyelid tacking is a temporary and non-surgical approach used in cattle to manage entropion, a condition where the eyelids roll inward, causing irritation to the eye. Eyelid tacking is often employed in cases where surgical correction is not immediately possible or when the condition is expected to resolve over time. In cattle can either be congenital rare; usually spastic, cicatricial and in young, dehydrated calves. Eyelid tacking procedure for entropion in cattle include temporary tacking sutures and surgical correction. Temporary tacking sutures First Bite • Create horizontal incision at the junction of haired and non-haired skin. • The incision should penetrate approximately half to three-quarters of the skin's thickness. • The width (length) of the incision should be between 0.5 to 0.75 centimetres. • Place 3-4 vertical or horizontal mattress, skin staples may also be used., Step 2 - Second incision Join the ends of initial incision by an elliptical incision: incision width equals extent of tissue requiring excision to evert eyelid margin into normal position . Control hemorrhage (usually minor) by direct pressure with surgical swabs. If in doubt as to how much skin to take, it is better to take too little and under correct than to take too much and over-correct. + Step 3- Excise skin Remove the incised area of eyelid and orbicularis oculi muscle with a sharp scissors., In most cases of eye removal, complete excision of orbital tissue is required. The retrobulbar musculature and the sheath of the optic nerve should be transected as far caudally as possible. ???? The skin incision can be closed using various stitching patterns with a nonabsorbable suture, such as No. 3 nylon. Common patterns include the Ford interlocking, cruciate, or simple continuous techniques. An interrupted suture should be placed in the medial canthal portion of the skin closure to allow for drainage facilitation., Techniques ???? Eye laceration repair, Techniques ???? Evisceration, Techniques Removing an entropion Eyelid tacking for entropion, Laceration Repair ???? Minimal to no debridement is required. Loss of skin prevents the reconstruction of the eyelid., Techniques ???? Exenteration, Step 1: Initial incision Inject local anesthetic (lidocaine Lidocaine/procaine Procaine hydrochloride intradermally to the area of skin to be excised. If the cornea is painful, consider the concurrent use of local anesthetic ophthalmic drops to anesthetize the cornea. Removing corneal discomfort will increase the likelihood of a calm, non-fidgety patient. Test local anesthetic efficacy with a needle. Trim the eyelashes and the hair around the eyelid margin for approximately 2-3 centimetres. To stabilize the eyelid for cutting, employ a metal lid plate (such as the Jaeger lid plate) or a sterile tongue depressor by inserting it under the eyelid into the fornix. Using a #15 blade, create an initial incision that is parallel to and positioned 3 millimetres away from the eyelid margin and about 1-2 mm from affected by entropion, incision depth includes most of orbicularis oculi muscle; incision length should be slightly longer than the length of defect to be corrected, as both ends of the skin excision section are very narrow. An eyelid plate may be used to spread and steady the eyelid and also protects the cornea (this image is of a canine patient). If only medial and lateral parts of the eyelid are affected, make two separate incisions. + Step 2 - Second incision Join the ends of initial incision by an elliptical incision: incision width equals extent of tissue requiring excision to evert eyelid margin into normal position . Control hemorrhage (usually minor) by direct pressure with surgical swabs. If in doubt as to how much skin to take, it is better to take too little and under correct than to take too much and over-correct., Understanding the anatomy of the third eyelid is of utmost importance. It consists of a T-shaped cartilage featuring a stem that courses ventromedially and a crossbar positioned parallel, approximately 1.5 mm from the free margin. ???? Employ a monofilament suture. The choice of suture size depends on the animal's size, ranging from 1-0 to 4-0. A cutting needle is necessary., • Create horizontal incision at the junction of haired and non-haired skin. • The incision should penetrate approximately half to three-quarters of the skin's thickness. • The width (length) of the incision should be between 0.5 to 0.75 centimetres. • Place 3-4 vertical or horizontal mattress, skin staples may also be used. Second Bite • Place the second incision parallel to the first one. • Position it close to the orbital rim. • The distance between the first and second incisions should approximate the degree of eyelid eversion or "roll-out" required. • It is advisable to slightly over-correct during the anesthesia phase due to the anticipated blepharospasm that may develop postoperatively. • Basically place sutures perpendicular to and approximately 2-3 mm from the lower eyelid margin., Exenteration ???? For closure, trim the eyelid margins and seal the lids using a simple continuous pattern with 0 suture material. Using 2-0 suture material with a needle can be less efficient in this procedure., If an aesthetically pleasing outcome is desired, a "trampoline" suture technique can be employed to reduce the sunken appearance of the orbit. However, this technique is not advisable in cases where there is periorbital infection or neoplasia present. The placement of a trampoline suture involves grasping the periosteum on the dorsal and ventral rims of the orbit using a simple continuous pattern with No. 2 polypropylene or an equivalent nonabsorbable suture. ???? The sutures are tightened to provide support to the overlying ocular skin. The skin is subsequently sutured using a Ford interlocking, cruciate, or simple continuous pattern with No. 2 or No. 3 nylon suture. The skin sutures are typically removed within 14 to 21 days, while the underlying trampoline sutures are left in place as permanent support., Eyelid tacking for entropion Hotz Celsus method Step 1: Initial incision Inject local anesthetic (lidocaine Lidocaine/procaine Procaine hydrochloride intradermally to the area of skin to be excised. If the cornea is painful, consider the concurrent use of local anesthetic ophthalmic drops to anesthetize the cornea. Removing corneal discomfort will increase the likelihood of a calm, non-fidgety patient. Test local anesthetic efficacy with a needle. Trim the eyelashes and the hair around the eyelid margin for approximately 2-3 centimetres. To stabilize the eyelid for cutting, employ a metal lid plate (such as the Jaeger lid plate) or a sterile tongue depressor by inserting it under the eyelid into the fornix. Using a #15 blade, create an initial incision that is parallel to and positioned 3 millimetres away from the eyelid margin and about 1-2 mm from affected by entropion, incision depth includes most of orbicularis oculi muscle; incision length should be slightly longer than the length of defect to be corrected, as both ends of the skin excision section are very narrow. An eyelid plate may be used to spread and steady the eyelid and also protects the cornea (this image is of a canine patient). If only medial and lateral parts of the eyelid are affected, make two separate incisions., Techniques ???? Enucleation, Third eyelid flap ???? Understanding the anatomy of the third eyelid is of utmost importance. It consists of a T-shaped cartilage featuring a stem that courses ventromedially and a crossbar positioned parallel, approximately 1.5 mm from the free margin.