Surgical Techniques and Outcomes in the Management of Pediatric Eyelid Burns: A Systematic Review.

PURPOSE: To evaluate the surgical techniques used in the management of eyelid burns among pediatric patients below 18 years old, focusing on the timing of interventions and patient outcomes.

METHODS

This systematic review was conducted in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. A comprehensive literature search was performed using PubMed, Embase, and Web of Science, targeting studies published between January 2000 and August 2024. Search terms included "burn," "injury," "release," "scar," "children," "pediatric," "eyelid," "contracture," and "reconstruction." A total of 51 studies were identified, of which 6 met the inclusion criteria and were selected for detailed review. All focused on pediatric patients with severe eyelid burns.

RESULTS

The review identified a range of surgical techniques, including antegrade foreheadplasty, Double Frost Suture technique, and early versus delayed surgical release. Antegrade foreheadplasty was effective in addressing upper eyelid contracture deformities, providing significant functional and aesthetic improvements. The Double Frost Suture technique was successful in preventing graft retraction and enhancing graft stability. The timing of surgical intervention was found to be crucial, with early release showing better outcomes in terms of ocular protection and faster recovery compared with delayed interventions.

CONCLUSIONS

The findings underscore the importance of a tailored approach in the surgical management of pediatric eyelid burns, with careful consideration of the timing and technique. While early surgical release generally yields better outcomes, the choice of technique should be guided by the specific needs of each patient. Further research is needed to refine these techniques and to better understand the long-term outcomes, particularly in complex cases involving extensive burns.