OBJECTIVE: To improve the method of vermillion flap and orbicularis oris bundle anastomosis in repair of transverse facial cleft. METHODS: Based on the precise fixed point, the modified vermillion flap was designed slender at the new corner of the upper lip, and was inserted into the lower lip after removing part tissue. The orbicularis oris was divided into two bands and cross-stitched. RESULTS: Fifteen patients with unilateral transverse facial cleft form the Children's Hospital of Zhejiang University during September 2016 and December 2018 were operated, and the position and shape of the commissure were almost normal. CONCLUSIONS The cosmetic effect and oral function are satisfactory when the modified vermillion flap and bundle anastomosis of orbicularis oris is used to repair transverse facial cleft.
Anastomosis, Surgical ; Child ; Cleft Lip ; surgery ; Facial Muscles ; surgery ; Humans ; Lip ; surgery ; Surgical Flaps ; surgery ; Treatment Outcome

Objective:To investigate the clinical features of children’s acute facial trauma, and to explore the clinical effects of plastic surgery in the repair of children’s acute facial trauma.Methods:The clinical data of children with acute facial trauma who were admitted to Children’s Hospital Affiliated to Zhejiang University School of Medicine from June 2017 to June 2018 were retrospectively analyzed. All children received plastic surgery treatment, and were followed up at 3, 6 and 12 months after operation. Scar cosmesis assessment and rating (SCAR) was used to evaluate the scar condition, and the parents’ satisfaction with scar was investigated. The clinical characteristics of acute facial trauma in children were analyzed. Graphpad prism 8.0.0 was used for statistical analysis, one-way ANOVA was used for comparison between groups, LSD- t test was used for pairwise comparison between groups, multivariate regression analysis was used to explore the main factors affecting parents’satisfaction with scar. P<0.05 showed that the difference was statistically significant. Results:A total of 338 children (364 wounds) with acute facial trauma were included, consisting of 223 males and 115 females, aged from 1 to 14 years, with an average of 4.5 years. All wounds were successfully repaired by plastic surgery. The SCAR scores at 3 months, 6 months and 12 months after operation were 2.9±1.0, 1.9±0.7 and 1.8±0.8 respectively, showing significant difference among there groups( P< 0.01). The SCAR score at 3 months after operation was significantly different from that at 6 and 12 months after operation ( P<0.01). There was no significant difference in SCAR score between 6 months and 12 months after operation ( P>0.05). The parents’ satisfaction scores at 3, 6 and 12 months after operation were 7.4±0.7, 7.9±0.7 and 8.2±0.8 respectively, showing significant difference among there groups( P<0.01). The parents’ satisfaction score at 12 months after operation was significantly different from that at 3 and 6 months after operation ( P<0.01). There was no significant difference in parents’satisfaction score between 3 months and 6 months after operation ( P>0.05). Multivariate regression analysis showed that whether there were multiple wound affected areas and scar width were the main factors influencing patients’ satisfaction with scar. Conclusions:Acute facial trauma in children is mostly caused by blunt trauma, and it is common in the forehead. According to the characteristics of the wound, using plastic surgery technique to repair children’s acute facial trauma can achieve the best wound healing and improve the prognosis of scar. It is expected to further improve the patient’satisfaction.

Objective:To investigate the clinical features of children’s acute facial trauma, and to explore the clinical effects of plastic surgery in the repair of children’s acute facial trauma.Methods:The clinical data of children with acute facial trauma who were admitted to Children’s Hospital Affiliated to Zhejiang University School of Medicine from June 2017 to June 2018 were retrospectively analyzed. All children received plastic surgery treatment, and were followed up at 3, 6 and 12 months after operation. Scar cosmesis assessment and rating (SCAR) was used to evaluate the scar condition, and the parents’ satisfaction with scar was investigated. The clinical characteristics of acute facial trauma in children were analyzed. Graphpad prism 8.0.0 was used for statistical analysis, one-way ANOVA was used for comparison between groups, LSD- t test was used for pairwise comparison between groups, multivariate regression analysis was used to explore the main factors affecting parents’satisfaction with scar. P<0.05 showed that the difference was statistically significant. Results:A total of 338 children (364 wounds) with acute facial trauma were included, consisting of 223 males and 115 females, aged from 1 to 14 years, with an average of 4.5 years. All wounds were successfully repaired by plastic surgery. The SCAR scores at 3 months, 6 months and 12 months after operation were 2.9±1.0, 1.9±0.7 and 1.8±0.8 respectively, showing significant difference among there groups( P< 0.01). The SCAR score at 3 months after operation was significantly different from that at 6 and 12 months after operation ( P<0.01). There was no significant difference in SCAR score between 6 months and 12 months after operation ( P>0.05). The parents’ satisfaction scores at 3, 6 and 12 months after operation were 7.4±0.7, 7.9±0.7 and 8.2±0.8 respectively, showing significant difference among there groups( P<0.01). The parents’ satisfaction score at 12 months after operation was significantly different from that at 3 and 6 months after operation ( P<0.01). There was no significant difference in parents’satisfaction score between 3 months and 6 months after operation ( P>0.05). Multivariate regression analysis showed that whether there were multiple wound affected areas and scar width were the main factors influencing patients’ satisfaction with scar. Conclusions:Acute facial trauma in children is mostly caused by blunt trauma, and it is common in the forehead. According to the characteristics of the wound, using plastic surgery technique to repair children’s acute facial trauma can achieve the best wound healing and improve the prognosis of scar. It is expected to further improve the patient’satisfaction.