Postoperative Evaluation of Skin Incision in External Dacryocystorhinostomy

Ophthalmic Plastic and Reconstructive Surgery
Vol. 20, No. 5, pp 358–361 ©2004 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.

Martin H. Devoto, M.D.*, Maria C. Zaffaroni, M.D.*, Francesco P. Bernardini, M.D., and Carlo de Conciliis, M.D.Consultores Oftalmológicos, Buenos Aires, Argentina; Genova, Italy; and Milan, Italy.

Purpose:
To evaluate the appearance of the skin incision in external dacryocystorhinostomy 6 weeks and 6 months after surgery.

Methods:
A prospective, interventional, noncomparative case series of consecutive cases of external dacryocystorhinostomy was performed by 3 surgeons. At 6 weeks and 6 months after surgery, patients were asked to grade their incision, and standardized photographs were evaluated by 3 blinded observers.

Results:
Thirty-four consecutive patients were admitted and followed for 6 months. Six weeks after surgery, 9 of 34 patients could not see their incision site (26%), 13 of 34 graded it as minimally visible (38%), 9 of 34 (26%) graded it as moderately visible, and 3 of 34 patients (9%) graded it as very visible (grade 3). Two of 34 patients (6%) were not satisfied with the appearance of the incision.

Six months after surgery, 15 of 34 patients (44%) could not see their incision site (grade 0), 16 of 34 (47%) graded it as minimally visible, 3 of 34 patients (9%) graded it as moderately visible, and no patient graded it as very visible.

All patients were satisfied with the appearance of their incision. Photographic evaluation of patients 6 weeks after surgery by the 3 observers showed an average score of 1.12, 1.18, and 1.24.

There was not a statistically significant difference between the observers (p  0.95). At 6 months after surgery, the average scores were 0.56, 0.74, and 0.79. There was not a statistically significant difference between the observers (p  0.43). The change in appearance of the incision at 6 weeks and at 6 months was statistically significant (p  0.044), as evaluated by patients and observers (p  0.001).

Conclusions:
The skin incision in external dacryocystorhinostomy is satisfactory to most patients. Its appearance is improved with time; 86% of the incisions were
graded invisible or minimally visible by observers and 91% by patients after 6 months.

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