Venous wall graft in the eyelid reconstruction: observations drawn from 64 cases.

The aim of this report is to illustrate the venous wall graft and to present the observations drawn from a large series of eyelid reconstructions performed with this method. Sixty-four patients underwent venous wall grafts, mostly after resection of invasive carcinomas of the eyelids and, in only one case, after traumatic injury. All patients had good functional and cosmetic results. The average follow-up time was 6.5 years. Few negligible complications were observed. Only two cases (3.1%) needed further surgical treatment. Vein graft is a reliable alternative to traditional procedures in replacing tarsus-conjunctival layer, achieving satisfactory results. A single surgical session is required, usually without complications.

Reconstruction of the tarsus-conjunctival layer using a venous wall graft.

PURPOSE: The repair of full-thickness defects of the eyelids poses a challenge, because the reconstruction of the tarsus-conjunctival layer often results in aesthetically and functionally unsatisfactory outcomes. The authors' aim was to create a new method to repair large tarsus-conjunctival losses and to examine the outcomes of its use. METHODS: Seven patients with invasive carcinoma of the eyelids underwent a venous wall graft. RESULTS: All patients had good to outstanding results and no complications. CONCLUSION: This new reconstruction of the deeper layer of the eyelid provides a useful alternative to traditional methods (composite grafts and full-thickness flaps). Our new surgical technique is easy to execute and has good functional and aesthetic results.

Is 2,3,5-pyrroletricarboxylic acid in hair a better risk indicator for melanoma than traditional epidemiologic measures for skin phenotype?

This study aims to assess type of melanin as a risk indicator for skin tumors, in a sample of melanoma cases and controls within a larger multicenter study (Helios 2), held in Europe and South America in 2001-2002. In each case and control, the melanin content in hair was assessed by three methods: 1) the amount of 2,3,5-pyrroletricarboxylic acid (PTCA); 2) the absorbance ratio with ultraviolet spectroscopy; and 3) the spectra of near-infrared spectroscopy. Statistical analysis was performed in a Bayesian setting, defining priors for confounders and effect modifiers from the larger study data set. Subjects with values of PTCA of less than 85 ng/mg carried an increased risk (26 vs. seven discordant pairs: odds ratio = 4.4, 95% confidence interval: 1.52, 14.54), adjusted by hair color, eye color, and number of nevi (n = > or =40). The absorbance ratio showed a weaker and nonsignificant odds ratio of 1.5. After correction by misclassification, near-infrared spectroscopy was associated with an odds ratio of 2.3 (95% confidence interval: 1.36, 4.22). The amount of PTCA is thus a strong and independent risk indicator for melanoma. Incorporating PTCA determination into epidemiologic studies is therefore recommended.