Step 10 Closure

Closure is usually performed in two layers - the periosteum and skin (Fig.2-27). Suturing of the orbicularis oculi muscle is difficult and of little value. Interrupted or running ressorbable periosteal sutures, such as 5-0 catgut, ensure that the soft tissue stripped from the anterior surface of the maxilla and zygoma are repositioned. A 6-0 nonresorbable or fast-resorbing suture is then run along the skin margin. If a lateral extension was made, one should place one or two deep resorbable sutures in the incised orbicularis oculi muscle overlying the lateral orbital rim.

Figure 2 27 Closure of periosteum with interrupted resorbable sutures.

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