The basic steps of cleft lip repair surgery are fixed-point design, incision and suture. There are many fixed-point design methods. Now only the lower triangular flap method is introduced. The steps are as follows.

1. Fixed point design

1) First find the point of the red lip: find the peak point D and the lowest point C of the healthy lip, and then press CB=CD to determine the point B, and the point B' is set at the thickest part of the red lip of the affected lip. Finally, B and B are stitched together to form the labial peak of the affected side.

2) Measure two basic data: from the bottom of the alar to the bottom of the columella, measure the width of the normal nostril and the bottom of the affected nostril respectively, and the difference between them is X. H measured from the midpoint of the contralateral nasal bottom to point D is the normal lip height, that is, the upper lip height that should be restored after the repair operation.

3) Set other points and underline them.

The fixing points a and A' are fixed on both sides of the nasal floor fissure. Let AA' be equal to the difference X of the width of the bottom of two nostrils, and make AA' equal after sewing. Connect AB. Subtract AB from normal lip height H to get Y, which is the lip height to be increased on the affected side. At point b, BE is about =y, almost parallel to the red edge of the lower lip. Take A' as the center, AB as the radius, B' as the center, Y (the lip height to be increased) as the radius, make an arc and intersect with B "(preferably B'B" is almost perpendicular to the red edge of the lip). Make an arc with b' b' as the center and BE as the radius, intersecting with e'. Connect the lines A' b', B' e' and E'B' (be careful not to draw the line B' b "or make an incision here). After correcting all points, dip the hypodermic needle into the skin with methylene blue, draw a line and fix it with iodine (Figure 2④⑤).

Cutting and sewing

The operation requires meticulous, light, small trauma, accurate incision and neat suture.

When cutting, first pinch the upper lip outside the incision with your fingers to reduce bleeding. Cut A'B ",b' e", A'B ",B'E' and E'B" in turn according to the design line. After incision, the upper lip of the healthy side can descend, forming a triangular crack at BE. Insert the B "e' b "triangular tissue flap formed on the affected side into this fissure. The wound edge of AB line is opposite to A' B' suture layer by layer in turn. Trim the red lip, according to the situation, adopt embedded or Z-shaped double triangular flap method to increase the fullness of the red lip. Generally speaking, patients with nasal deformity advocate postponing the radical operation of nasal deformity after 13 years old.

The fissure of complete cleft lip is wide and the tension is high, so it needs to be cut in the vestibular sulcus for invisible separation, which is convenient for tissue suture in place.

Polizel's therapy

1. Fix the upper lip with steel wire lip arch tape for 2 weeks to prevent the wound from cracking and reduce scar healing.

2. After children are awake from basic anesthesia, double elbow joints should be fixed with splint bandages to avoid scratching wounds and reduce the tension of labial arch.

3. Gently wipe the lip wound with 3% hydrogen peroxide and 4% boric acid alcohol to prevent the blood scab from covering and affecting the wound healing.

4. The wound was removed within 5 days.