A split-face comparison of cold compress application and electrocautery in upper eyelid blepharoplasty

Year 2026, Volume: 9 Issue: 2, 266 - 270, 12.03.2026

Burcu Işık , Matin Suleymanzade , Ezgi Karataş

https://izlik.org/JA82NX45YS

Abstract

Aims: To compare the effects of intraoperative electrocautery and cold compress application on postoperative edema and ecchymosis in upper eyelid blepharoplasty using a split-face design.
Methods: This prospective, observer-blinded, split-face study included 45 patients (90 eyelids) who underwent bilateral upper eyelid blepharoplasty. In each patient, the right eyelid was treated with electrocautery, in which haemostasis was achieved using bipolar cautery, while the contralateral left eyelid was treated with cold compress application, in which sterile cold compresses were applied for bleeding control without the use of cautery. Postoperative edema and ecchymosis were assessed at the 1-hour, 1-day, and 1-week postoperative time points using standardized photographs evaluated by a blinded observer. The severity of edema and ecchymosis was graded using a 5-point scale. Given the paired nature of the split-face design, statistical analyses were performed using the Wilcoxon signed-rank test, and a p value <0.05 was considered statistically significant.
Results: Of the 45 patients, 32 (70.7%) were male and 13 (29.3%) were female, with a mean age of 46.7±8.5 years. When edema parameters were compared between electrocautery-treated and cold compress-treated eyelids, edema scores were numerically higher in the electrocautery-treated eyelids at all postoperative time points; however, these differences were not statistically significant (p>0.05 for all comparisons). In contrast, ecchymosis scores were significantly lower in the electrocautery-treated eyelids at the 1-hour postoperative assessment (p=0.03), whereas no statistically significant differences were observed at the 1-day and 1-week evaluations (p>0.05 for both).
Conclusion: Intraoperative cold compress application resulted in postoperative edema and ecchymosis outcomes comparable to those achieved with electrocautery during upper eyelid blepharoplasty. Within the limitations of this exploratory split-face study and short-term follow-up, cold compress may be considered a tissue-sparing adjunct in selected cases, particularly beyond the immediate postoperative period. Larger, prospective studies incorporating long-term outcomes and patient-reported measures
are warranted to further define its clinical role.

Keywords

Blepharoplasty , cold temperature , ecchymosis , edema , electrocautery , haemostasis

Ethical Statement

This study was approved by the Biruni University Scientific Research Ethics Committee (Decision No: 2024-BİAREK/12-28, dated 28 July 2025). All procedures were conducted in accordance with the ethical standards of the institutional and national research committee and with the principles of the Declaration of Helsinki. Written informed consent was obtained from all participants prior to enrollment in the study. Identifying information of participants was not collected, and all data were processed anonymously. No additional ethical risks or conflicts of interest related to human subjects were identified during the review process.

Supporting Institution

Not applicable

Thanks

None

Üst Göz Kapağı Blefaroplastisinde Soğuk Kompres Uygulaması ve Elektrokoterizasyonun Karşılaştırmalı Analizi

https://izlik.org/JA82NX45YS

Abstract

Amaç:
Split-face tasarım kullanılarak üst göz kapağı blefaroplastisinde intraoperatif elektrokoter ve soğuk kompres uygulamasının postoperatif ödem ve ekimoz üzerindeki etkilerini karşılaştırmak.
Yöntemler:
Bu prospektif, randomize, gözlemci kör çalışmaya bilateral üst blefaroplasti uygulanan 45 hasta (90 göz kapağı) dahil edildi. Her hastada sağ göz kapağı bipolar koter ile hemostaz sağlanan **elektrokoter grubunu**, sol göz kapağı ise koter kullanılmaksızın kanama kontrolü için steril soğuk kompres uygulanan **soğuk kompres grubunu** oluşturdu. Postoperatif ödem ve ekimoz, standartize fotoğraflar üzerinden kör bir gözlemci tarafından 1. saat, 1. gün ve 1. haftada değerlendirildi. Her iki parametre için şiddet 5 puanlık bir skalada derecelendirildi. İstatistiksel analizlerde Mann–Whitney U testi kullanıldı ve p < 0,05 anlamlı kabul edildi.
Bulgular:
Kırk beş hastanın 32’si (%70,7) erkek, 13’ü (%29,3) kadındı ve ortalama yaş 46,7 ± 8,5 yıl idi. Tüm postoperatif zaman noktalarında ödem skorları elektrokoter grubunda daha yüksek saptanırken, ekimoz skorları 1. saatte ve 1. günde soğuk kompres grubunda hafifçe daha düşük izlendi. Ancak bu farkların hiçbiri istatistiksel olarak anlamlı değildi (tüm karşılaştırmalar için p > 0,05).
Sonuç:
Üst göz kapağı blefaroplastisinde intraoperatif soğuk kompres uygulaması, elektrokoter ile karşılaştırılabilir düzeyde hemostatik etkinlik ve postoperatif sonuçlar sağlar ve ödem veya ekimozu artırmaz. İstatistiksel olarak üstün olmasa da, özellikle termal hasarın en aza indirilmesinin istendiği olgularda soğuk kompres güvenli ve dokuya daha az travmatik bir alternatif olarak düşünülebilir. Bu bulguların doğrulanması için daha geniş örneklemli, çok merkezli çalışmalara ihtiyaç vardır.

Keywords

blefaroplasti , soğuk kompress , ekimoz , ödem , elektrokoter , hemostaz

Ethical Statement

Bu çalışma, Biruni Üniversitesi Bilimsel Araştırmalar Etik Kurulu tarafından onaylanmıştır (Karar No: 2024-BİAREK/12-28, Tarih: 28.07.2025). Tüm süreçler, kurumun ve ulusal etik kurulların standartlarına uygun olarak ve Helsinki Bildirgesi ilkeleri çerçevesinde yürütülmüştür. Çalışmaya katılan tüm bireylerden bilgilendirilmiş yazılı onam alınmıştır. Katılımcıların kişisel bilgileri kayıt altına alınmamış olup tüm veriler anonim olarak değerlendirilmiştir. Çalışma kapsamında insan katılımcılara yönelik ek bir etik risk bulunmamaktadır.

Supporting Institution

Yoktur

Thanks

Bulunmamaktadır

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