Cooper Joshua M, Paige Keith T
Department of Plastic and Reconstructive Surgery, Virginia Mason Medical Center, Seattle, Washington 98101, USA.
J Craniofac Surg. 2006 Mar;17(2):340-3. doi: 10.1097/00001665-200603000-00023.
The purpose of our retrospective review is to examine our method and outcomes for the application of octyl-2-cyanoacrylate for the repair of primary and revision cleft lips in both pediatric and adult patients. Records and photographs were reviewed and analyzed for patient age, type of cleft, revision or primary repair, complications, length of follow-up, and aesthetic outcomes. Eighteen patients, both children and adults, who underwent cleft lip repairs using tissue adhesive performed by a single surgeon between 1999 and 2003 were included. Twelve patients underwent primary repair and 6 patients underwent revision repair. Repairs were performed using the Millard rotation advancement technique and the Mohler variant. The lateral advancement flap was kept long and redundant in its transverse dimension to create a pressure fit everting the skin edges with minimal sutures to set up the closure for application of the tissue adhesive. Seventeen of eighteen patients had excellent cosmetic outcomes. One patient had minor necrosis of the tip of the advancement flap. No allergic reactions, wound infections, or dehiscences occurred. The use of octyl-2-cyanoacrylate for the skin closure of primary and revision cleft lip repairs in both children and adults results in excellent cosmetic outcomes. Employing our pressure-fit technique for skin eversion prior to application of the tissue adhesive may be advantageous. The lack of suture removal in the pediatric population and decreased operative time are additional benefits.
我们进行这项回顾性研究的目的是，考察我们在小儿及成年患者中应用2-氰基丙烯酸辛酯修复一期及二期唇裂的方法和效果。对患者的年龄、唇裂类型、二期修复或一期修复、并发症、随访时间及美学效果等记录和照片进行了回顾与分析。纳入了1999年至2003年间由同一位外科医生使用组织粘合剂进行唇裂修复的18例患者，包括儿童和成人。其中12例患者接受一期修复，6例患者接受二期修复。修复采用Millard旋转推进技术及Mohler改良术式。外侧推进瓣在横向维度上保持较长且冗余，以形成压力贴合，使皮肤边缘外翻，用最少的缝线进行缝合，为应用组织粘合剂做好闭合准备。18例患者中有17例获得了极佳的美容效果。1例患者推进瓣尖端出现轻微坏死。未发生过敏反应、伤口感染或裂开。在小儿及成年患者中，应用2-氰基丙烯酸辛酯进行一期及二期唇裂修复的皮肤闭合，可获得极佳的美容效果。在应用组织粘合剂之前采用我们的压力贴合技术使皮肤外翻可能具有优势。小儿患者无需拆线以及手术时间缩短是额外的益处。
