Leonard Aimee L, Hanke C William
Laser and Skin Surgery Center of Indiana, Carmel, Indiana 46032, USA.
J Am Acad Dermatol. 2007 Nov;57(5):832-5. doi: 10.1016/j.jaad.2006.07.030.
The lip plays critical roles in both function and cosmesis. Many options exist for postsurgical reconstruction following excision or Mohs micrographic surgery on the lip. Second intention healing is generally reserved only for superficial and small postsurgical defects of the lip vermilion.
We sought to evaluate second intention healing of the lip for intermediate and large partial thickness, postsurgical defects through a retrospective review of medical charts in conjunction with telephone interviews. Complication rates, time to reepithelialization, and patient satisfaction were determined for 25 patients who underwent second intention healing on the lip following Mohs micrographic surgery for non-melanoma skin cancer.
The majority of patients in the study demonstrated good to excellent cosmetic and functional results with minimal complications. Time to complete reepithelialization averaged 25 days. Patient satisfaction with both the healing process and final cosmetic result was very high.
The study is a small retrospective case series. Using patient satisfaction as a primary endpoint, a limiting factor may be recall bias.
Second intention healing is an effective and satisfactory management strategy for intermediate and large postsurgical defects of the lip vermilion, including those with extension to cutaneous lip and underlying orbicularis muscle.
唇部在功能和美观方面都起着关键作用。唇部切除或莫氏显微外科手术后的重建有多种选择。二期愈合通常仅适用于唇部唇红缘的浅表和小的术后缺损。
我们通过回顾病历并结合电话访谈，试图评估唇部中等和大的部分厚度术后缺损的二期愈合情况。确定了25例因非黑色素瘤皮肤癌接受莫氏显微外科手术后唇部二期愈合患者的并发症发生率、重新上皮化时间和患者满意度。
研究中的大多数患者显示出良好至极佳的美容和功能效果，并发症极少。完全重新上皮化的平均时间为25天。患者对愈合过程和最终美容效果的满意度非常高。
该研究是一个小型回顾性病例系列。以患者满意度作为主要终点，一个限制因素可能是回忆偏倚。
二期愈合是唇部唇红缘中等和大的术后缺损的一种有效且令人满意的管理策略，包括那些延伸至唇部皮肤和下方轮匝肌的缺损。
