four-flap surgery

Four-valve is used for the repair of cleft palate. Four-valve operation is also called four-valve operation. This operation is a kind of post-push surgery. It is a modified VY suture. After improvement, it still needs to cut off the iliac artery on both sides, but its length is shorter, which can avoid the periosteal flap necrosis. Curing disease: Indication Four-valve is suitable for hard and soft cleft palate. Contraindications Cases with anemia, upper respiratory tract infection, inflammation of the ear and nasal passages, and grade III enlargement of the tonsils, especially those with congenital heart malformations, should be examined and treated by the relevant department before surgery. Preoperative preparation You should make a sputum guard before surgery and try it for 1~2d to make it accustomed to eating. Those whose trailing edge is too long should be worn away to prevent nausea and vomiting. The nose was started with 0.25% chloramphenicol 2 days before surgery. Prepare blood 150 ~ 200ml. Adult patients need to be treated with oral cavity 1 to 2 days before surgery, and often contain Du Bell liquid. One hour before surgery, a proper amount of atropine was injected subcutaneously. In the morning, the patient is fasted, and the surgery is delayed. The sick child can take about 200ml of sugar water 4 hours before surgery. Surgical procedure 1. Along the sacral side of the alveolar ridge 1 to 2 mm, the Langenbeck method is used to make a loose incision on both sides, reaching the posterior border of the maxillary nodules on both sides. 2. Cut the edges of the cracks on both sides and cut the soft palate and uvula neatly. 3, from the hard soft palate junction obliquely to the first premolar, obliquely cut straight to the loose incision. This forms I, II, III, IV4 mucoperiosteal flaps. 4, first with a periosteal separator, peeling and picking up the I and II valves, and then separating the III and IV valves, respectively, in the vicinity of the maxillary nodule incision, the large hole was removed, and the iliac artery was severed. Then the wing hook is revealed at the trailing edge to be cut. 5. At the posterior border of the humerus at the junction of the soft and soft palate, the nasal mucosa is separated from the diaphragm, the nasal mucosa is preserved, and the diaphragm is cut to loosen the soft palate. 6. Using the No. 1 silk thread, the membranous tissue at the junction of the III and IV soft and soft palate is firstly sutured, and the suture is used for pulling and fixing. The suture is then sutured in 3 layers for suture, first nasal mucosa, posterior muscle layer and oral mucosa. 7. The suture periosteum of the I and II valves was sutured with the No. 1 silk thread, and the tip was embedded between the III and IV valves, and the III and IV valves were sutured intermittently. A circular suture is placed at the tip of the tip to avoid perforation. 8. Finally, fill the bone surface of the loose wound and cover the iodoform gauze and wear the protective plate. complication 1. Loose hemorrhoids at the ligation of the aorta, and should be partially filled with pressure to stop bleeding. However, care should be taken not to cause suture cracking due to the hemostasis process. 2, the junction of 4 mucoperiosteum flaps due to blood supply, suture technique, etc., can occur necrosis, off-line and split, resulting in perforation.

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