Use of Silicon and Negative Pressure in the Treatment of the Contracted Socket

Abstract

Abstract: : Purpose: To assess the utility of a simple technique in the treatment of patients with inadequate socket lining with or without any orbital volume deficit Methods: Eleven patients with socket contraction were followed for more than three years. Six patients had eye socket contraction but a normal orbital volume and were classified as class I, the other five had also orbital volume deficit and were classified as class II. The surgical treatment was to use a skin or mucosa graft for class I, and a dermofat graft for class II. A simple technique based on a silicon stent and a negative pressure between the graft and the recipient bed was used in all of the patients. Results: the main outcomes were to obtain a good orbital volume and a confortable use of prosthetic eye. The average follow up period was 18 months (range between 4 to 42 months). All patients had a restored orbital volume and were able to wear a prosthetic eye with comfort and a good cosmetic appearance. Conclusions: A variety of surgical technique have been developed to obtain a tight and stable adhesion between the graft and its recipient bed on the expanded socket. The use of room–temperature vulcanizing silicone conformer is easier and accurate because it fills entirely the cavity, and it pushes the graft uniformly against the recipient bed in all its surface without the need of a technician who should prepare many conformers to be sufficient big to fill out the eye socket. To drain off any blood or fluid and to improve the take of the graft a continuum vacuum is created between the graft and the recipient bed. The choice of treatment of socket contraction should be established according to the degree of orbital volume deficit and the amount of residual conjunctiva.

Keywords: orbit • wound healing • anatomy