Department of Reconstructive and Plastic Surgery, A.V.Vishnevsky Institute of Surgery of the Russian Academy of Medical Sciences, Moscow, Russia.
Burns. 2010 Aug;36(5):698-702. doi: 10.1016/j.burns.2009.09.002. Epub 2009 Dec 6.
One of the consequences of face burn is upper lip deformation with philtrum injury. The philtrum's absence poses severe cosmetic defects. A literature review shows no effective developed technique which allows the surgeon to restore the upper lip and the philtrum in a single-stage procedure. The article presents a new method for burn-damaged philtrum restoration. Two scar stripes are deliberately left in place above the upper lip where the normal philtral ridges should be. The width of these two stripes (ridges) should be around 4mm. The upper lip scars, lateral both ridges and between them, are excised forming the philtral dimple. The wound is covered with a split thickness skin graft. Two U-shaped sutures are led through the skin graft, both scar stripes and deeper through the underlying tissues between stripes. A bolster is plunged between the ridges in order to fill the dimple and is fixed by the tie-over dressing with tension. The skin transplant lying laterally to the ridges is covered with a separate tie-over dressing. The bolster is being kept in place for the duration of 7 days. As a result, the scar ridges preserve their height and the dimple keeps its depth. Good long-time follow-up results (up to 7 years) were observed in all 18 patients. In most cases the dimple can be slightly smoothed with time. The suggested method of philtrum restoration is an important component of the burned upper lip reconstruction as part of the post-burn facial resurfacing.
面部烧伤的后果之一是上唇变形和人中损伤。人中缺失会造成严重的美容缺陷。文献回顾显示，目前尚无有效的技术能让外科医生在一个阶段同时修复上唇和人中。本文提出了一种修复烧伤人中的新方法。在上唇应该有正常人中嵴的位置故意留下两条瘢痕条纹。这两条条纹（嵴）的宽度应约为 4mm。切除上唇瘢痕，包括两侧的嵴和它们之间的部分，形成人中凹。用断层皮片覆盖伤口。通过皮片、两条瘢痕条纹和条纹之间的深层组织引导两条 U 形缝线。在嵴之间插入一个衬垫以填充凹痕，并通过带有张力的加压包扎固定。位于嵴外侧的皮片用单独的加压包扎覆盖。衬垫留置 7 天。结果，瘢痕嵴保持其高度，凹痕保持其深度。18 例患者均获得良好的长期随访结果（最长达 7 年）。在大多数情况下，凹痕会随着时间的推移而略微变平。该人中修复方法是烧伤后面部修复的重要组成部分，可作为修复烧伤上唇的一部分。
