Clinical Application And Discussion Of Repairing Methods Of Upper Lip Ectropion Deformity

ObjectiveThis paper concludes and summarizes the reconstructive methods of the upper lip ectropion deformity,analyzes and summarizes the advantages and disadvantages of various types of surgery,explore the best repair methods of different degrees of the upper lip ectropion deformity,so as to provide experience and reference for clinical treatment.MethodsTo collect the clinical data of 30 cases with upper lip ectropion deformity who were treated in the Department of Burn and Plastic Surgery,the First Hospital of Shanxi Medical University from January 2016 to January 2019,and the causes,degree of deformity,repair methods and recovery status of upper lip ectropion were retrospectively analyzed.In this study,based on the aesthetic principles of lip repair,Z-plasty,V-Y plasty,nasolabial flap and full-thickness skin graft were used to repair the different degrees of ectropion deformity caused by superficial lesions of upper lip.A score table was drawn to analyze the postoperative complications,recovery of upper lip shape,scar of the operation area and patient satisfaction.Results(1)Direct observation method: In this study,all the flaps and skin grafts of 30 patients survived after different surgical treatments,29 of them with wound healing at stage I,and 1 patient with free skin graft in the philtrum area lost slight epidermis in the graft area after removal of suture,and the wound healed after 1 week of dressing change,except for 2 cases with swollen upper lip repaired by nasolabial flap,the correction effectof postoperative ectropion deformity of upper lip of the other patients was good,with smooth and symmetrical lip shape and no obvious stretch and deformation of surrounding tissues.(2)Appearance & Function evaluation method: The total score of upper lip ectropion deformity caused by the superficial tissue lesions was more than 5 points after being repaired by different schemes,which indicated that the function and shape of lip after the above-mentioned methods had achieved ideal repair effect,The operation area scar is small,the aesthetic appearance is better,the patient satisfaction is high.Conclusions(1)The blood supply of the lips is rich,and there are two ways to correct the upper lip ectropion deformity: skin transplantation and skin flap repair.Among them,the survival rate of the local skin flap is high,and the incidence of necrosis and infection rate is low.On the basis of following the aesthetic principle of the lip,the local skin flap should be given priority to correction of the upper lip ectropion deformity,to obtain a stable aesthetic effect.(2)In this study,the upper lip ectropion deformity caused by superficial scar contracture was the main object of study,and the repair methods of various types of upper lip ectropion deformity were summarized as follows.(1)the mild ectropion deformity of the upper lip was treated with Z-plasty,V-Yplasty,the clinical application of two kinds of operative methods comparison found:Compared with V-Y plasty,the flexible application of triangular flap in Z-plasty is more suitable for the ectropion deformity of the upper lip caused by mild longitudinal cord-like scar contracture or secondary cord-like scar after cleft lip surgery,the postoperative scar is not obvious,and the upper lip has a good aesthetic effect;(2)For moderate and severe upper lip ectropion deformity,the use of unilateral or bilateral nasolabial flap can effectively prolong the height of the upper lip and correct the ectropion deformity of the red lip.Especially for elderly patients,the correction of ectropion deformity of the upper lip with loose tissue inthe nasolabial groove area can effectively avoid the deformation of the nasal surface groove;(3)According to the aesthetic structure of the philtrum area,the free transplantation of the "tie-like" skin graft was adopted to repair the ectropion deformity of the philtrum area caused by the adhesion between the nasal column and the upper lip,which could further strengthen the formation of the structure in the philtrum area while correcting the ectropion deformity of the upper lip.(3)Suborbital nerve block combined with buccal nerve block is effective in the operation of upper lip ectropion deformity.There is no obvious swelling and deformation in the operation area,and it does not affect the shape of upper lip,which is conducive to the adjustment and judgment of lip shape during the operation.