The utility of the ‘temporary marginal lid suture’ in facilitating Mohs surgery for tumours involving the eyelid

Abstract

Funding sources: none. Conflicts of interest: none declared. Madam, The application of temporary sutures placed through the tarsus of the lower eyelid is well documented in the oculoplastic and dermatological surgery literature. They are generally used as suspension sutures (Frost sutures) to reduce the risk of ectropion due to wound contraction after reconstructive procedures involving the lower eyelid.1–5 The use of temporary sutures to facilitate Mohs surgical extirpation of eyelid tumours has not previously been described. Mohs surgical excision of skin cancers involving the eyelids presents unique challenges to the surgeon. The very thin, mobile nature of eyelid skin and the need to evert the lid to incise the conjunctiva for marginal lid tumours makes the incision of tissue difficult and the harvesting and orientation of an optimal Mohs surgery specimen technically demanding. Methods to facilitate stabilization of the tissue include the use of chalazion clamps, jaeger plates and manual stretching of the skin by the surgical assistant.6, 7 We describe the use of a marginal eyelid suture to stabilize the eyelid, stretch the tissue and evert the lid when incising the conjunctiva, which in our experience is a useful tool to ensure high‐quality Mohs surgery specimens for frozen section tissue processing.