Modified LeMesurier Repair

Modified LeMesurier repair for the repair of unilateral cleft lip. Treatment of diseases: cleft lip 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 Fixed point According to the triangular flap repair, 1, 2, 3, 4, 5, and 6 points are stipulated, so that the 5 and 6 sutures are equal to the width of the bottom of the healthy side. Red lip high point 1 and human mid-cut point 2 are determined at the healthy side lip peak, and the distance of 1~2 is copied to point 3 as the repaired side red lip high point, so that 1~2=2 ~3, that is, to maintain the original shape of its lip arch. The midpoint of the healthy side of the nose is fixed at 4, and the distance of 4 to 1 is the normal upper lip height, that is, the height of the lip after repair. Measure the width of the healthy nostrils (from the root of the healthy side to the root of the nasal column), then point 5 and 6 on both sides of the affected side; make the width of the root of the point 5 to the nasal column and point 6 to The width of the roots of the nose is added to equal the width of the bottom of the healthy side. The bottom of the nose is symmetrical. For 3 to 7 lines, the length is equal to 1 to 4 minus 3 to 5 lines, which can be slightly longer, but should not exceed the middle of the lip. At the thickest part of the affected side, set the point 8 from 8 to 9, and set a point 10 at a right angle from 8 to 9 below 9 so that the length of 8 to 9 is equal to 9 to 10. Let 6 to 10 be equal to 3 to 5. If the 6 to 10 line is too long, a small piece of triangular skin can be removed from the upper nasal part to make it completely equal. 2. Cut open Use the No. 11 blade to cut the skin first, then cut it through the whole layer, so that the skin, muscles and mucous membranes are cut neatly on one level. Ligation of the labial arteries and clamping of other bleeding points. The 6, 9 and 8 flaps were twisted to the nasal side, and the incision was inserted into the side of the nasal column to form a nasal base. 3. Stitching The same method is used for sneak separation, and then layered suture and lip red cross stitching.

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