Objective To discuss the effect of cheiloplasty we designed an improved Black procedure that with microsurgical technique the tissue from lateral lips on the bilateral cleft lip were used to reconstruct the skin of anterior lip and the vermilion tubercle. Methods 36 cases of congenital bilateral complete cleft lip deformity were repaired through improved Black procedure and microsurgical method, including 19 patients with very short prolabium tissue, repairing insufficient skin and vermilion tubercle tissue by fissure lateral lip tissue. Results Following-up for 3 months to 3 years after treatment showed that 36 patients were with normal and symmetrical high of anterior lips, the chubby vermilion tubercles, the natural morphous of labial archs, the appropriate strength of labrums and the vermilion tubercles and lips without color difference, and the effects were satisfactory. Conclusion The improved Black procedure redeems the shortages of traditional Black procedure for the case with bilateralcomplete cleft lip and smaller anterior lip, such as the deficient height of anterior lips, eclabium and inadequate vermilion tubercles. By applying microsurgical technique, the procedure gives better upper lip function and aesthetic effect, and therefore it is worthy to be recommended in clinic.

AIM: To observe the restorative effect of compound flap transplantation on the scar of functional position after burns. METHODS: Twenty inpatients with scar of functional position after burns treated by compound flap transplantation were selected from the Department of Burns and Plastic Surgery, First Hospital Affiliated to Liuzhou Medical College between May 2002 and December 2005, and all patients knew and agreed with the items. All patients were removed of the scar of functional position under whole-anesthetization to transplant the acellular allogenic dermis (It was manufactured by Beijing Dieyalaifu Biotechnological Co., Ltd of Guangxi Beisheng Pharmaceutical Group, and it was characteristics of soft, flexible with better tenacity. Besides, it was milk white in net with two kinds of surfaces: smooth surfaces and rough surfaces). Acellular allogenic dermis of rough surface closely adhered to the wound with smooth surface up toward, and the wound was sutured. Autologous skin grafts (obtained from scalp, trunk or extremities) were transplanted into acellular allogenic dermis, and the flap gaps shall be kept as small as possible, so as to reduce the exposure of acellular allogenic dermis. Wounds were dressed at 2 weeks postoperation, and the follow-up was conducted regularly. The survival rate, contraction rate, the smooth and glossy degree, skin elasticity, joint function, and healing of donors were observed from 2 weeks to one year after the surgery. RESULTS: Twenty patients were followed after compound flap transplantation with the time ranged from one month to one year, including 4 patients within 1-3 months, 3 patients within 3-6 months, and 13 patients within 6 months to one year. Thirty functional positions out of 31 healed in the first period. While the flap in another position was influenced by exposed acellular allogenic dermis due to over large gaps among autoallergic flaps. The survival rate of transplanted flap was 93.00%, and the flaps transplanted were smooth in appearance with proper elasticity and less contraction, and the joint range of motion was better. The skin of donor site recovered better. CONCLUSION: Compound flaps can significantly ameliorate the functional disturbance and deformities caused by scar of functional position after burns with high survival rate.