外伤后下唇缺损的修复方法

The treatment of lower lip defect after trauma

目的介绍因外伤导致的不同程度下唇缺损修复的手术方法选择及体会。方法本组23例患者,其中12例缺损占下唇1/5～3/5,采取直接对位缝合;7例合并肌层损伤者采用推进皮瓣法;4例缺损超过下唇全长2/3,伴肌层缺损者应用邻位鼻唇沟肌皮瓣法修复。结果除1例人咬伤创口感染外,22例患者创口均一期愈合,部分患者随访3个月～1年,下唇功能及形态恢复良好。结论在治疗中根据病情选择不同的术式,特别指出对于下唇全层缺损,邻位鼻唇沟肌皮瓣法操作简便,皮瓣成活机率高,无明显术后并发症,是达到理想下唇形态及美容效果的修复方法之一。

Objective To describe the experience and surgical methods for the treatment of lower lip defect after trauma.Methods There were twelve cases whose defect was about one fifth to three fifth of the lip,that we sutured directly.Seven cases combined with orbicularis muscle injur were treated with advanced skin flap and the other four cases were repaired with ortho-nasolabial flaps whose defect was larger than two thirds of the lip.Results The operative incision of twenty-two cases was primary healing,except one human bite case, all achieved good results functionally and cosmetically with the follow-up of three months to one year.Conclusions Different surgical techniques shoud be s e l e c t e d a c c o r d i n g t o t h e c o n d i t i o n o f p a t i e n t s.I nparticular,ortho-nasolabial flaps were operated simply and flaps survived well without any severe postoperative complications for the patients with full- thickness lower lip defect after trauma.Based on the principle of satisfactory lower lip contour and cosmetic effect,this technique would be one of the effective methods for surgical repairing.