Department of Surgery, Angell Animal Medical Center, Boston, MA.
J Am Vet Med Assoc. 2023 Feb 2;261(4):526-535. doi: 10.2460/javma.22.09.0421. Print 2023 Apr 1.
To describe the author's surgical guidelines for the effective use of a modified von Langenbeck technique, utilizing bilateral bipedicle mucoperiosteal flaps in the dog.
12 client-owned dogs with cleft palate defects of the hard and soft palates.
12 dogs with cleft palate were presented to the Angell Animal Medical Center from May 20, 2015, to March 24, 2022. The patient's ages ranged from 5 months to 3 years. All 12 dogs had closure of the hard palate clefts by use of modifications of the original von Langenbeck technique in this prospective study.
Successful closure of the cleft (hard and soft) palate defects was achieved in all 12 dogs in a single surgical procedure. A small residual opening was noted at the level of the incisive papilla in each dog; this was of no clinical consequence in this report.
The von Langenbeck technique, using the simple closure modifications reported, was effective in closing both narrow and wide defects. Successful execution requires the complete elevation of each flap, which facilitates their tension-free advancement over the palatal cleft. Vertical mattress sutures evert the flap margins, allowing for direct collagen surface contact for proper healing. Placement of sutures in the rugal folds increases the tissue purchase to reduce the risk of suture cut-out. Fine interrupted sutures, placed between the vertical mattress sutures, maintains the proper alignment of the incisional margins. The author waits a minimum of 5 months before closing cleft palate defects, enabling the donor areas time to mature and improving their ability to retain sutures more effectively.
描述作者在犬中有效使用改良 von Langenbeck 技术的手术指南，该技术利用双侧双蒂黏膜骨膜瓣。
12 只具有硬腭和软腭裂裂隙的患犬。
2015 年 5 月 20 日至 2022 年 3 月 24 日，安吉尔动物医疗中心收治了 12 只具有腭裂裂隙的患犬。这些犬的年龄在 5 个月至 3 岁之间。在这项前瞻性研究中，所有 12 只犬均采用改良的原始 von Langenbeck 技术来关闭硬腭裂裂隙。
在所有 12 只犬中，均通过单次手术成功关闭了腭裂（硬腭和软腭）裂隙。每只犬的切牙乳头水平都有一个小的残余开口，但在本报告中这并无临床意义。
使用所报告的简单闭合改良技术的 von Langenbeck 技术在闭合狭窄和宽裂隙方面均有效。成功实施需要完全抬起每个皮瓣，这有利于它们在腭裂上无张力推进。垂直褥式缝线使皮瓣边缘外翻，允许胶原表面直接接触以实现适当愈合。在皱襞处放置缝线可增加组织抓握力，降低缝线脱出的风险。放置在垂直褥式缝线之间的精细间断缝线可保持切口边缘的正确对齐。作者至少等待 5 个月再关闭腭裂裂隙，使供区有时间成熟，从而提高其更有效地保留缝线的能力。
