Rhee Samuel T, Colville Christopher, Buchman Steven R
Section of Plastic Surgery, Department of Surgery, University of Michigan Medical Center, Ann Arbor, USA.
Pediatr Emerg Care. 2004 Jan;20(1):40-2. doi: 10.1097/01.pec.0000106243.72265.f6.
Large lip avulsion injuries that involve significant tissue loss to the lip vermilion and other local landmarks can often pose a surgical dilemma for the reconstructive surgeon. Immediate reconstruction of these injuries are frequently performed using local flaps and adjacent tissue transfer to close the defect, but these repairs frequently suffer from the unfortunate consequence of increased associated scarring and further permanent distortion of the local anatomy. We present 2 patients sustaining dog bite injuries associated with extensive traumatic tissue loss to the lip vermilion and other local landmarks. These patients were treated conservatively with excellent functional and cosmetic results. A single minor surgical revision of 1 patient's cupid's bow was performed 1 year after injury. In cases of significant traumatic avulsion involving the lip vermilion and the perioral composite soft tissue, even with injuries including delicate anatomic landmarks, healing by secondary intention can be instituted as the initial treatment of choice in younger patients, often providing optimal results.
涉及唇红部及其他局部标志大量组织缺失的大型唇部撕脱伤，往往会给重建外科医生带来手术难题。这些损伤的即刻重建通常采用局部皮瓣和邻近组织转移来闭合缺损，但这些修复常常会出现瘢痕增加以及局部解剖结构进一步永久性变形等不良后果。我们报告2例因犬咬伤导致唇红部及其他局部标志广泛创伤性组织缺失的患者。这些患者接受了保守治疗，获得了良好的功能和美容效果。其中1例患者在受伤1年后对其唇弓进行了一次小的手术修复。在涉及唇红部和口周复合软组织的严重创伤性撕脱病例中，即使损伤包括精细的解剖标志，对于年轻患者，二期愈合作为初始治疗选择通常可取得最佳效果。
