Denadai Rafael, Raposo-Amaral Cassio Eduardo, Buzzo Celso Luiz, Raposo-Amaral Cesar Augusto
Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, São Paulo, Brazil.
Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital, Campinas, São Paulo, Brazil.
J Plast Reconstr Aesthet Surg. 2015 Nov;68(11):1522-8. doi: 10.1016/j.bjps.2015.07.019. Epub 2015 Jul 26.
Lower lip defects after squamous cell carcinoma (SCC) excisions have been repaired by several surgical techniques. However, the functional reconstruction of full-thickness defects of the lower lip remains a therapeutic challenge. We therefore evaluated functional results of the modified Bernard-Webster flap for the reconstruction of full-thickness lower lip defects after SCC excisions.
A prospective study was performed on all patients with lower lip full-thickness defects after SCC excisions greater than 1/3 of the lip, reconstructed with the modified Bernard-Webster flap in 2011-2013. Functional (sphincter, motor, and sensory functions) postoperative results were evaluated according to criteria previously adopted.
Twelve lower lip defects were reconstructed without complications, except for two (16.7%) wound dehiscence successfully managed. Ten (83.3%) patients presented transient and permanent functional abnormalities in the recent and late postoperative assessments. Ten (83.3%) patients classified the late functional results as satisfactory.
The modified Bernard-Webster flap proved to be an excellent alternative to repair full-thickness lower lip defects with more than 1/3 of the lower lip length, as it allowed the use of similar neighboring tissues, could be performed in one stage, and was functionally effective.
鳞状细胞癌（SCC）切除术后的下唇缺损已通过多种手术技术进行修复。然而，下唇全层缺损的功能重建仍然是一项治疗挑战。因此，我们评估了改良Bernard-Webster皮瓣用于SCC切除术后全层下唇缺损重建的功能效果。
对2011年至2013年期间所有下唇全层缺损大于唇长1/3的SCC切除术后患者进行前瞻性研究，采用改良Bernard-Webster皮瓣进行重建。根据先前采用的标准评估术后功能（括约肌、运动和感觉功能）结果。
12例下唇缺损重建无并发症，除2例（16.7%）伤口裂开经成功处理。10例（83.3%）患者在近期和晚期术后评估中出现短暂和永久性功能异常。10例（83.3%）患者将晚期功能结果评为满意。
改良Bernard-Webster皮瓣被证明是修复下唇长度超过1/3的全层下唇缺损的极佳选择，因为它允许使用相似的邻近组织，可一期完成手术，且功能有效。
