Yen Cheng-I, Chen Hung-Chang, Hsiao Yen-Chang, Chang Shu-Yin, Chuang Shiow-Shuh
From the Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taipei, Taiwan.
Ann Plast Surg. 2019 Nov;83(5):513-517. doi: 10.1097/SAP.0000000000001981.
The philtrum plays an important role in determining the shape and form of the upper lip and creates individual identity. Postburn scar contracture in this area often leads to severe functional and aesthetic disfigurement. In this report, we present a novel method of philtrum reconstruction using full-thickness skin grafts (FTSGs) after burn injury.
Between August 2011 and October 2017, 8 patients with postburn philtrum deformity who underwent FTSG for replacement of the whole upper lip unit with a silastic tube for creation of the philtral dimple were included. A review of photographic documentation was used to evaluate the aesthetic results.
The size of FTSG ranged from 4 × 9 to 6 × 17 cm. No patient had immediate postoperative complications, such as hematoma, infection, or necrosis. The crests of the ridges preserved their height and length, and the dimple remained visible after an average follow-up of 30.4 months (range, 3-69 months). All patients were satisfied with both functional and aesthetic results.
This technique of single-stage reconstruction of the upper lip and philtrum with FTSG and silastic tube produced favorable results in the formation of the philtral ridges and the dimple. Through thoughtful preoperative design, meticulous scar release, and skin grafting, satisfactory functional and aesthetic results are achievable.
人中在决定上唇的形状和形态以及塑造个体特征方面起着重要作用。该区域烧伤后瘢痕挛缩常导致严重的功能和美观缺陷。在本报告中，我们介绍一种烧伤后使用全厚皮片（FTSG）进行人中重建的新方法。
纳入2011年8月至2017年10月期间8例烧伤后人中畸形患者，这些患者接受了FTSG手术，用硅胶管替换整个上唇单位以形成人中凹。通过回顾照片记录来评估美学效果。
FTSG的大小范围为4×9至6×17厘米。没有患者出现术后即刻并发症，如血肿、感染或坏死。嵴的高度和长度得以保留，平均随访30.4个月（范围3 - 69个月）后人中凹仍可见。所有患者对功能和美学效果均满意。
这种使用FTSG和硅胶管对上唇和人中进行一期重建的技术，在人中嵴和人中凹的形成方面产生了良好效果。通过精心的术前设计、细致的瘢痕松解和植皮，可实现令人满意的功能和美学效果。
