Zellner Elizabeth Gordon, Pfaff Miles J, Steinbacher Derek M
New Haven, Conn. From Plastic and Reconstructive Surgery, Yale University School of Medicine.
Plast Reconstr Surg. 2015 May;135(5):1449-1453. doi: 10.1097/PRS.0000000000001187.
The goal of primary cleft lip repair is to unify the lip elements and achieve a nearly normal appearance. Many techniques can confer satisfactory results; however, scarring and contour irregularities may persist. Lipofilling can modulate scar formation and enable soft-tissue augmentation. The authors hypothesize that fat grafting during immediate cleft lip repair may be of benefit. Patients who underwent primary cleft lip repair with and without immediate fat grafting were compared. Postoperative photographs were analyzed by three blinded reviewers. Cronbach statistics and a two-tailed t-test were used. Scar analysis revealed statistically significant (p < 0.05) improvement in scar appearance and contour of the fat-grafted cleft lip repair. Immediate fat grafting may be a promising strategy to improve lip appearance, contour, and scarring during primary cleft lip repair.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
一期唇裂修复的目标是使唇部各部分统一并实现接近正常的外观。许多技术都能带来满意的效果;然而,瘢痕形成和轮廓不规则可能会持续存在。脂肪填充可以调节瘢痕形成并实现软组织填充。作者推测在一期唇裂修复时进行脂肪移植可能有益。对接受了一期唇裂修复且有或没有即刻脂肪移植的患者进行了比较。由三名不知情的评审人员对术后照片进行分析。使用了克朗巴哈统计量和双尾t检验。瘢痕分析显示,脂肪移植的唇裂修复在瘢痕外观和轮廓方面有统计学显著改善(p < 0.05)。即刻脂肪移植可能是改善一期唇裂修复时唇部外观、轮廓和瘢痕的一种有前景的策略。
临床问题/证据水平:治疗性,III级。