改良Abbe唇瓣修复上唇中度缺损的临床应用

Clinical application of modified Abbe flap in repair of moderate defects of the upper lip

目的应用改良Abbe唇瓣修复上唇中度缺损并探讨其断蒂时间。方法在经典的Abbe唇瓣的基础上，就唇瓣的设计、蒂部的切取及断蒂时间等进行改良，修复上唇中度缺损患者12例。手术分两期：Ⅰ期行改良Abbe唇瓣转移术，合并鼻畸形者同时行相应修复；Ⅱ期于术后9d断蒂并行局部整形。结果术后9d断蒂的改良Abbe唇瓣全部成活，唇部外形及表情功能恢复满意，鼻部外形相应改善。结论改良Abbe唇瓣简便易行，一方面术后改善了患者上唇的外形、表情功能及面中部整体形态，另一方面明显缩短了断蒂时间和疗程，减少了患者的痛苦，尤其适用于单、双侧唇裂术后继发上唇中度缺损及合并鼻畸形的修复。

Objective To evaluate the application of modified Abbe flap in repairing moderate defects of the upper lip and time point to divide the pedicle. Methods Classic Abbe flap was modified in its design, pedicle cutting and dividing time, which was used to repair moderate defect of the upper lip in 12 cases. Surgery was divided into two phases： one with modified Abbe flap surgery was per- formed for the combined nasal deformity repair simultaneously, and then the pedicle was divided 9 days after surgery. Results 12 patients underwent modified Abbe flap. No vascular complications were found in these flaps. Upper lip shape was well and satisfactory functional recovery, correspond- ing improvement in nasal appearance. Conclusions The surgery that the modified Abbe flap with the pedicle is divided 9 days after surgery is very simple. On one hand, it greatly improves the patient＇s ap- pearance and function of the upper lip, improve the overall shape of midface, on the other hand, divid- ing pedicle time is significantly shorter than in the past, specially reducing the suffering of patients and duration. It is particularly suitable for unilateral and bilateral cleft lip of the upper lip on secondary moderate deformities and combined nasal deformities.