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Simultaneous correction of scars and tissue deficiency with composite grafts in secondary cleft lip deformity

Authors
 Dong Won Lee  ;  Young Seok Kim  ;  Be-young Yun Park 
Citation
 JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, Vol.70(7) : 419-427, 2012 
Journal Title
 JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY 
ISSN
 0278-2391 
Issue Date
2012
MeSH
Adolescent ; Adult ; Child ; Child, Preschool ; Cicatrix/pathology ; Cicatrix/surgery* ; Cicatrix, Hypertrophic/surgery ; Cleft Lip/surgery* ; Color ; Esthetics ; Female ; Follow-Up Studies ; Graft Survival ; Humans ; Lip/pathology ; Lip/surgery* ; Male ; Middle Aged ; Postoperative Complications/surgery* ; Skin Pigmentation/physiology ; Skin Transplantation/methods* ; Spectrophotometry/methods ; Subcutaneous Fat/transplantation* ; Treatment Outcome ; Young Adult
Keywords
Adolescent ; Adult ; Child ; Child, Preschool ; Cicatrix/pathology ; Cicatrix/surgery* ; Cicatrix, Hypertrophic/surgery ; Cleft Lip/surgery* ; Color ; Esthetics ; Female ; Follow-Up Studies ; Graft Survival ; Humans ; Lip/pathology ; Lip/surgery* ; Male ; Middle Aged ; Postoperative Complications/surgery* ; Skin Pigmentation/physiology ; Skin Transplantation/methods* ; Spectrophotometry/methods ; Subcutaneous Fat/transplantation* ; Treatment Outcome ; Young Adult
Abstract
PURPOSE: In secondary cleft lip deformities, repetitive surgeries lead to increased tension and deformities in the upper lip, ultimately resulting in new deformities such as wide scars and a tight lip. The simultaneous correction of a wide scar and tissue deficiency in the upper lip is paradoxical unless sufficient tissue is supplied to the scant upper lip. The authors describe a method to transfer composite tissue for the improvement of secondary cleft lip deformities and present an analysis of the outcomes. MATERIALS AND METHODS: Ninety-one patients with secondary cleft lip, a wide scar, and tight lip were enrolled. After complete excision of the scar, the defect was covered with a composite graft that included skin and subcutaneous fat. The results were rated by 2 investigators blinded to the image of the scar and the morphology of the upper lip. The skin color of the 25 grafts was analyzed using a narrowband spectrophotometer using the Commission International d'Eclairage L*a*b* color coordinates. RESULTS: All grafts survived without sequelae. The scores of the scar images and general morphology were 8.3/10 and 8.2/10, respectively. Spectrophotometric analysis displayed no differences between the composite tissues and normal upper lip skin in each color coordinate, indicating that the composite tissue had a good color match with a normal upper lip. CONCLUSIONS: The use of a composite graft on the upper lip can be a reliable option to correct a wide hypertrophic scar and tight lip simultaneously, resulting in a satisfactory scar image and an improvement of upper lip morphology.
Full Text
http://www.sciencedirect.com/science/article/pii/S0278239112002716
DOI
22698297
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Plastic and Reconstructive Surgery (성형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Young Seok(김영석) ORCID logo https://orcid.org/0000-0002-0981-2107
Park, Beyoung Yun(박병윤)
Lee, Dong Won(이동원) ORCID logo https://orcid.org/0000-0003-0046-3139
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91027
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