Laissez-faire approach for medial canthus tumours
Reviewed by Jaya Myneni

This is a retrospective comparative case series of patients who underwent reconstruction of a medial canthal defect using laissez-faire approach (LFS), or a full-thickness skin graft (FTSG). The surgical options were discussed with the patient and the treatment decision was based on patient choice. LFS technique involved the use of Sorsban, alginate dressing, which was sutured into the wound with non-absorbable sutures positioned along facial tension lines to dictate the direction of healing. Donor sites for FTSG were chosen based on the size of the defect, tissue availability and suitability. Sixty-eight patients of whom 93% had basal cell carcinoma were included and followed up for a mean duration of 32 months. There was no statistically significant difference in the size of the defect or follow-up duration between the groups. In FTSG group, 10 of 32 (31%) patients had postoperative complications (22% – cicatricial sequelae, 9% – poor colour match), whereas, in LFS group, postoperative complications were encountered only in 8% (5% – cicatricial sequelae, 3% – poor colour match). This was statistically significant. The advantages of LFS appear to be reduced surgical time, avoiding the need for further reconstruction, reduced postoperative morbidity and reduced donor site morbidity. The authors, therefore, recommend laissez-faire as a primary technique rather than current approach where this is reserved for patients where reconstruction methods are not possible.

Medial canthal defects following tumour excision: To reconstruct or not to reconstruct?
Shafi F, Rathore D, Johnson A, et al.
ORBIT
2017;36(2):64-8