What is the surgical approach when sewing up lid-margin lacerations?

The key for sewing up eyelids is good cosmesis. You want the lid lashes to align properly and to avoid notching. There are many ways of sewing up the eyelid, but probably the best way is to start by placing a silk suture at the lid margin for good alignment, before sewing the rest of the laceration.

You can think of the eyelid as having two parts: the anterior lamella (composed of skin and orbicularis muscle) and a posterior lamella (the tarsal place and inner palpebral conjunctiva). You want to close each of these layers … such as placing a matress suture to oppose the tarsus and simple interrupted sutures for the skin and muscle.