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Objective:To investigate the hemostatic effect of epinephrine saline rinse solution in cleft palate repair.Methods:A total of 100 children who underwent cleft palate repair in the operating room of the Second Affiliated Hospital of Shantou University Medical College from 2018 to 2020 were selected, Among them, 51 were males and 49 females, aged from 6 months to 12 years, with an average (2.5±2.49) years. The patients were divided into two groups according to whether to use epinephrine saline flushing fluid: in group A, 43 cases were treated with adrenaline saline irrigation solution to wash the incision during the operation; gauze soaked in rinse solution was used to fill the oral cavity before endotracheal intubation and extubation after operation; in B group of 57 cases, no intraoperative rinses were used. The intraoperative blood loss and operation duration were compared between the two groups.Results:Intraoperative use in group A after adrenaline saline rinses showed that the intraoperative blood loss of children (16.23±4.88) ml was significantly lower than that of group B (19.26±4.13) ml. The duration of operation in group A (109.79±40.27) min was significantly shorter than that in group B (137.16±50.47) min, The difference was statistically significant ( t=2.92, P<0.05). Conclusions:The incision is rinsed with epinephrine saline solution during cleft palate repair. In addition, before endotracheal intubation and extubation after operation, gauze soaked in rinsing solution is used to fill the oral cavity, which could significantly reduce the amount of bleeding and shorten the operation time.
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Objective To explore the effectiveness of modified Bardach two-flap palatoplasty combined modified Furlow double-opposing Z-plasty in wide palatal cleft repair.Methods 80 patients aged 2-18 years old with Ⅲ cleft palate from our department were divided into two groups,the experimental group (n=40) was repaired with modified Bardach two-flaps palatoplasty combined modified Furlow double-opposing Z-plasty (modified B+F technique).The control group (n =40) was repaired with Sommerlad levator muscle of palatine velum reconstruction (S technique).Results The healing of incisions was better in the experimental group than the control group.The fistula rate in the experimental group was 2.5％,which seemed to be remarkable lower than that of the control group (7.5％) post operation one month.Conclusions Application modified Bardach two-flaps palatoplasty combined modified Furlow double-opposing Z-plasty in wide palatal cleft will promote healing of incisions,reduce the occurrence rate of cleft palate fistuia,inhibit the scar contracture of soft palate,maintain the length of soft palate,augment movement of soft palate,and improve the speech quality of patients.
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Objective To evaluate the effect of living skin equivalents (LSE) constructed of mixed autologous and allogeneic skin cells and human amnion which served as a matrix on repairing scar contracture of the hand in a patient with recessive dystrophic epidermolysis bullosa (RDEB).Methods Skin tissues were obtained from a patient with RDEB and her mother,and epidermal keratinocytes and dermal fibroblasts were isolated from these tissues and cultured in vitro separately.Human amnion was obtained from the placenta of an unrelated healthy parturient undergoing cesarean delivery,and served as a matrix of the LSE.The autologous and allogeneic fibroblasts were mixed and seeded on the stromal side of the amnion,and then the autologous and allogeneic keratinocytes were mixed and seeded on the epithelial side of the amnion,so as to construct the human amnion-LSE (AM-LSE).Histological examination was performed to observe the structure of the skin tissues obtained from the patient and her mother,and immunofluorescence staining was conducted to detect the expression of type Ⅶ collagen in the skin tissues of the patient and her mother and in the AM-LSE.The AM-LSE was grafted on the skin defects of the patient after release of scar contracture of the hand.After grafting,the survival status of the AM-LSE graft and repairing effect on the wounds were evaluated.Results The constructed AM-LSE consisted of dermis,multilayered and fully differentiated epidermis and well-developed basement membrane.Immunofluorescence examination revealed that type Ⅶ collagen was linearly distributed along the basement membrane.Half a year after grafting,the AM-LSE survived well,and no obvious rejection reaction was observed.No blisters or ulcers occurred at the recipient sites,and the scar contracture was mild.The grafted area showed normal skin color with soft texture.The patient could grab and hold things,which had met self-care requirements of daily living.Conclusions The AM-LSE constructed of mixed autologous and allogeneic skin cells have good histological structures,and can be grafted on the wounds after resection of the scars in a RDEB patient.After grafting,no obvious rejection reaction was observed,and the skin was not liable to develop blisters,ulcers or scar contracture due to friction.
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Objective To discuss the preventive measures of anterior palatal fistula by modified the operation of cleft palate. Methods For 23 patients of complete cleft palate with alveolar ridge cleft, bilateral mucoperiosteum flap was moved forward as possible so as to close fistula front of hard palate, and incised junction of the hard and soft palate to prolong soft palate and the wound was repaired by buccal mucosal flap.The incidence of anterior palatal fistula and velopharyngeal closure after operation was observed. Results Twenty-three patients were rechecked 1 month after operation ,there was no anterior palatal fistula occurring,10 cases were examined by epipharyngoscope 1 year after operation,the velopharyngeal closure was 90%-100%. Six cases were followed up for 6 months,the velopharyngeal closure was 80%-85%. Conclusions For second-stage operation methods of anterior palatal fistula, there are too many discussions of selection criterias, advantages and disadvantages. If first-stage operation is taken measures to prevent anterior palatal fistula or decrease the diameter of fistula as possible. It reduces percentage of second-stage operation or decreases the difficulty. It should get more attention in the clinical works.
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Objective To analyze the efficacy of repairing unilateral cleft lip (UCL) with Millard method, and explore the individual operative procedure. Methods According to the difference of lip height between non-cleft and cleft sides, MillardⅠ, MillardⅡ or modified Millard Ⅱ operative approach was chosen to repair UCL, then the clinical effect of operation was evaluated. Results The ideal operative effects were obtained in 208 cases of UCL using various operative approaches based on the individual deformity. There were consistent lip height between both sides, normal vermillion bulk and satisfactory facial appearance after operation. Conclusion The satisfactory efficacy could be obtained by choosing Millard method's operative approaches based on the individual deformity. The modified Millard operative approach could repair all kinds of UCL.