SURGICAL TREATMENT OF LOWER EYELID ECTROPION BY TRANSPOSITION OF THE SKIN-MUSCLE FLAP OF THE UPPER EYELID
R.A. Pakhomova
,
A.A. Pilnikov,
V.V. Moskalenko,
E.K. Saribekyan,
V.Ya. Kolesnik,
V.V. Zatsarinniy,
D.V. Kudryavtsev,
I.G. Buzel,
T.F. Kochetova,
V.A. Rybchenko,
D.I. Sergeev
ABSTRACT
Background. Cicatrical ectropion of the lower eyelid is a common complication in patients with blast and shrapnel injuries of the face. Eyelid deformation leads to functional disorders (exposition keratitis, lacrimation, lagophthalmos) and requires surgical correction. In cases with pronounced scarring, the use of standard skin grafts or cantopexy may be ineffective.
Purpose. To evaluate the effectiveness of using the upper eyelid skin-muscle flap in the surgical treatment of cicatricial ectropion of the lower eyelid using the clinical case of the participant of the Special Military Operation (SVO) with the consequences of a shrapnel wound.
Materials and methods. The article describes a case of a patient with post-traumatic cicatricial ectropion that developed after being wounded in a combat zone. The lower eyelid was reconstructed by transposition of a vascularized skin-muscle flap from the upper eyelid. The surgical technique, features of the preoperative tissue condition, anatomical and functional parameters, and postoperative observations were analyzed.
Results. Ectropion was eliminated, eyelid position stability was achieved with restoration of contact with the eyeball. Superficial healing was completed without signs of necrosis. Symptoms of irritation and lagophthalmos were eliminated.
Conclusion. Transposition of the upper eyelid skin-muscle flap is a reliable and physiologically sound method for correcting ectropion in cases of severe cicatricial changes, especially when it is impossible to use free skin grafts or flaps with axial blood supply.
ABOUT AUTHORS
Head of the Department of Plastic Surgery Medical Institute of Continuing Education, Russian Biotechnological University (ROSBIOTECH); Moscow, Russia
https://orcid.org/0000-0002-3681-4685
Head of the Center for Plastic Surgery Central Military Clinical Hospital named after A.A. Vishnevskiy; Krasnogorsk, Russia; Honored Doctor RF
Head of the Department of Plastic Surgery Central Military Clinical Hospital named after A.A. Vishnevskiy; Krasnogorsk, Russia
https://orcid.org/0000-0003-0149-0390
Associate Professor of the Department of Plastic Surgery Medical Institute of Continuing Education, Russian Biotechnological University (ROSBIOTECH); Moscow, Russia
https://orcid.org/0000-0003-0827-7998
Graduate student of Medical Institute of Continuing Education, Russian Biotechnological University (ROSBIOTECH); Moscow, Russia
https://orcid.org/0009-0001-6572-2392
Associate Professor of the Department of Plastic Surgery of Medical Institute of Continuing Education, Russian Biotechnological University (ROSBIOTECH); Moscow, Russia
https://orcid.org/0009-0001-1154-2126
Associate Professor of the Department of Plastic Surgery of Medical Institute of Continuing Education, Russian Biotechnological University (ROSBIOTECH); Moscow, Russia
https://orcid.org/0000-0003-3654-9356
Associate Professor of the Department of Ophthalmology of Krasnoyarsk State Medical University named after Professor V.F. Voyno-Yasenetsky; Krasnoyarsk, Russia
https://orcid.org/0000-0002-9894-6413
Plastic surgeon Central Military Clinical Hospital named after A.A. Vishnevskiy; Krasnogorsk, Russia
Associate Professor of the Department of Plastic Surgery Medical Institute of Continuing Education, Russian Biotechnological University (ROSBIOTECH); Moscow, Russia
https://orcid.org/0009-0005-5296-4535
Resident of Medical Institute of Continuing Education, Russian Biotechnological University (ROSBIOTECH); Moscow, Russia
https://orcid.org/0009-0009-3300-006X
Graduate student of Medical Institute of Continuing Education, Russian Biotechnological University (ROSBIOTECH); Moscow, Russia
https://orcid.org/0000-0002-6412-9861
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KEYWORDS: cicatricial ectropion, transposition flap, mine blast injury, reconstructive ophthalmic surgery
CORRESPONDENCE: Vasiliy Ya. Kolesnik, e-mail: v.kolesnik@bk.ru
FOR CITATIONS: Pakhomova R.A., Pilnikov A.A., Moskalenko V.V. et al. Surgical Treatment of Lower Eyelid eEctropion by Transposition of the Skin-muscle Flap of the Upper Eyelid // Bulletin of the Medical Institute of Continuing Education. — 2025. — V. 5, № 4. — P. 35–39. — DOI 10.36107/2782-1714_2025-5-4-35-39.
FUNDING SOURCE: The authors declare no funding for the study.
DECLARATION OF COMPETING INTEREST: The authors declare no apparent or potential conflicts of interest related to the publication of this article.
DATA AVAILABILITY STATEMENT: Data from the current study are available from the corresponding author upon reasonable request.
AUTHOR CONTRIBUTIONS
V.V. Moskalenko, A.A. Pilnikov, V.A. Rybchenko, R.A. Pakhomova, E.K. Saribekyan — concept and design of the study, editing
V.A. Rybchenko, V.Ya. Kolesnik, D.V. Kudryavtsev, I.G. Buzel, D.I. Sergeev — collection and processing of material, data processing
V.A. Rybchenko, V.Ya. Kolesnik, E.K. Saribekyan, V.V. Zatsarinniy, T.F. Kochetova — writing text
INFORMED CONSENT FOR PUBLICATION: authors received written consent from patients for publication of medical data and photographs.
COMPLIANCE WITH ETHICAL PRINCIPLES: The study conducted complies with the standards of the Declaration of Helsinki (Declaration Helsinki) as amended in 2024. The study protocol's compliance with ethical principles was confirmed by the Local Ethics Committee Medical Institute of Continuing Education, Russian Biotechnology University (ROSBIOTECH) on (Volokolamskoe highway, 11, Moscow, Russia), protocol № №12/7-4 from 28 october 2025.