Foao III Method of Restoration

Foao III repair is used for the repair of bilateral cleft lip. Treating diseases: cleft lip Indication Foao III method is suitable for bilateral III degree cleft lip cases (first type of bilateral cleft lip) within 3 years old (suitable for 1 to 3 years old). For older children, such as 4 to 6 years old or older, it is advisable to use elastic bandage compression. Under normal circumstances, the child wears an elastic bandage for 1 to 2 months, and the anterior lip and anterior jaw of the patient can retreat significantly. At this point, surgery can be performed. In addition, you need to refer to the unilateral cleft lip repair indications. 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 Design 1 When the front lip is fixed, first point a and c point respectively on the lower and lower sides of the base of the nasal column. Then, point b and point d are respectively determined at the boundary between the lower edge and the side edge of the red lip of the front lip, and a-b=c-d. Then, point e and point f are respectively set at the upper and lower sides of point b and point d, so that both aeb and cfd are obtuse, and b-e line and d-f line are both smaller than 6-8 mm, and e-f 2. Cut open In the front lip, cut the a-e-b line, c-f-d line and the horizontal line below the red edge of the lip between point b and point d according to the design. For the operation, refer to the straight line repair method. In the lips on both sides, the a'-e'-b' line and the c'-f'-d' line are respectively cut according to the design, and all are cut in full layer. When cut, it should be perpendicular to the skin surface to form two lip-red tissue flaps B and B' (the skin of both tissue flaps is removed, while the lip red, mucous membrane and muscle layer are retained to repair the anterior lip and Lips). The incision on both sides of the nasal vestibule and the incision on both sides of the vestibular sulcus can be referred to the straight line repair method. In the two nasal side vestibules, four incisions, a'-b', a-b, c-d and c'-d', are used. The lines are respectively extended to both sides of the cracks in the nostrils on both sides (about 1 cm), and as a vertical relaxation incision, a transverse incision (about 2 to 3 cm) is made at both side vestibular grooves as a horizontal relaxation incision. However, if the anterior ankle is repaired at the same time, the vestibular groove incision must be designed separately. 3. Separation Along the e-f incision line, use a small scissors to sharply separate deep and under the incision to form a mucosal flap A. Then use a small pair of scissors to trim the red lip tissue on both sides of the crack, forming two red lip B and B'. Through the transverse incision at the vestibular groove, the stripper is used to extend up the surface of the periosteum up to the base of the alar, for extensive sneak separation to loosen the nose, reduce tension, and return the upper lip and nose to normal position. The wound cavity is temporarily filled with gauze to stop bleeding. Use a small pair of scissors to sneak in the vertical relaxation incision so that the wound edges on both sides of the nose can be successfully sutured. A mucosal flap A and two lip red flaps B and B' are formed, respectively. For the method of sneak separation of the vestibular part and the base of the nose, refer to 9.4.1 Straight line repair method. 4. Stitching Refer to 9.4.1 Straight line repair method, with the fixed points as the mark, according to the order of oral mucosa, muscle layer and skin layer, suture the wounds in 3 layers. However, Veau emphasizes that a thin wire is used to penetrate the anterior lip subcutaneous tissue to fix the bilateral lip muscles to the subcutaneous tissue of the anterior lip to reduce tension. When suturing, if a'-e'-b' line>a-e-b line and/or c'-f'-d' line>c-f-d line are found, a wedge shape is to be cut under the nose wing. organization. Finally, the B-lobes and B' flaps on both sides are study and relatively sutured in the middle of the front lip; the upper edge is sutured with the residual lip of the anterior lip, and the suture should be 1 mm away from the red edge of the lip to avoid affecting the shape of the lip. The lower edge is stitched with the A-valve. The B and B' flaps can also be made into a growing triangle, which is then cross-stitched. complication There may be secondary deformities such as a low nose tip and a slight depression of the front lip. Can be selected for secondary surgery.