Glover method for bilateral cleft lip surgery

Glover double cleft lip repair for the repair of bilateral cleft lip. Treating diseases: cleft lip Indication Glover's bilateral cleft lip repair is applied to the repair of bilateral II degree and I degree cleft lip with inconspicuous anterior lip and anterior maxilla. Not suitable for the repair of III degree and II degree cleft lip with small front lip. This method can complete the surgical treatment once, without the shortcomings of the upper lip and the upper lip too tight, and there will be no postoperative complications such as upper upper lip protruding, lower posterior contraction and varus. Preoperative preparation Cleft lip disease children need to be fully and carefully prepared before surgery. 1. Understand and correct bad diet and sleep habits before admission. Within 3 days after admission, you should know if you have a respiratory infection or other infectious disease, and perform local and systemic examinations, including heart, lung condition, nutritional status and weight. Local presence or absence of eczema, erosion, swelling and so on. Thoracic examination should be performed to focus on the presence of congenital heart disease and thymic hypertrophy. Blood tests should also be performed. Hemoglobin, white blood cells, and clotting time should be in the normal range. Otherwise, the cause should be identified and treated, and surgery should be performed after recovery. 2. Before the operation, take a picture of the front, side and front back position to record the nose and lip deformity. 3. 3d before surgery should start and insist on using a spoon to feed liquid food or breast milk, so that the postoperative system can fully adapt to this feeding method, avoiding the crying of sick children caused by hunger after surgery, resulting in increased tension in the operating area. 4. 1d before surgery should be prepared for skin, antibiotic skin test, if necessary, with blood for blood transfusion preparation. 5. Fasting 6h before surgery. If the sick child is crying due to hunger, oral 10% glucose 100ml can be taken 3 to 4 hours before surgery. Atropine antispasmodic and sedatives were injected 30 min before surgery. 6. Prepare a metal lip bow or wire lead pellet for reduction before surgery. Surgical procedure There are many anesthesia methods for cleft lip surgery, but they can be classified into local anesthesia and general anesthesia. Larger children and adults can undergo surgery under local anesthesia; general anesthesia is used in infants and young children. At this time, it should be based on safety and ensuring the smoothness of the respiratory tract. In recent years, -hydroxybutyrate and thiopental sodium have been used as basic anesthesia, and anesthesia with axillary nerve block or ketamine plus sacral nerve block anesthesia has achieved good results. Surgery can also be performed under general anesthesia with an endotracheal intubation (via an oral cannula). 1. According to the fixed point method of the straight line repair method, the fixed point design is performed on the front lip and the left and right outer lips. 1 Front lip fixed point: point a and c point respectively on the outer side of the base of the nasal column, and make it a certain distance from the base of the nasal column. The b point and the d point are respectively determined at the intersection of the lower edge of the red lip of the front lip and the side edge. Let a-b=c-d, and point b and point d be the high points of the lips on both sides. Then point e and f at the junction of the red lips and the oral mucosa below the b and d points. And make b-e=d-f. 2 Both sides of the lip fixed point: a' point and c' point on the base of the two sides of the nose, so that a', a, c, c' four points on a horizontal line, and a point and a point, After the c-point and the c'-point are joined together, the size of the nostrils on both sides is the same. The b' point and the d' point are respectively determined on the red lips of the thickest part of the red lips on both sides, so that a'-b'=a-b=c-d=c'-d'. If a-b is smaller than a'-b' and/or c-d is smaller than c'-d', the a-b line and/or the c-d line may be curved to make the length equal, and vice versa. Of course. Then, below the b' point and the d' point of the red lips on both sides, the e' point and the f' point are respectively determined so that b'-e'=b-e=d-f=d'-f'. 2. According to the surgical design, the incision is made separately. However, it should be noted that when the left and right lateral lips are incision, only the skin and muscle layers are cut, the oral mucosa is retained, and a mucosal tissue flap is formed respectively; at the same time, a red lip tissue is formed at the front ends of the left and right lateral lips. valve. However, when the front lip is incision, a full-thickness incision is required (when the modified method is used, the mucosa is retained to close the frontal jaw wound). 3. Pick up the front lip (including the red lips and white lips), and then transfer the mucosal tissue flaps on both sides to the back of the front lip (ie, the front of the front jaw), and suture them relatively, then left and right The muscle layer of the lips (the orbicularis) is relatively sutured. 4. Reset the raised front lip and suture it with the upper lip on each side. Finally, under the red lips of the front lip, the two red lips of the left and right lips are cross-stitched. complication There may be secondary deformities such as a low nose, a slight depression of the front lip, a necrosis of the lower lip of the anterior lip, and a thin red lip tissue in the lower lip of the anterior lip, and a red lip depression. Can be selected for secondary surgery. In addition, this method can also occur anterior lip blood flow obstruction, anterior lip flap tissue necrosis and other complications, should be noted.

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