Millard's method for bilateral cleft lip repair

Millard's bilateral cleft lip repair is used for the repair of bilateral cleft lip. Treating diseases: cleft lip Indication Millard's bilateral cleft lip repair method has two types of surgery, the first method and the second method. The first method is actually a surgical method in which Millard's unilateral cleft lip repair method (rotary advancement method) is applied to bilateral cleft lip repair. It is suitable for the repair of bilateral II degree cleft lip (second type of bilateral cleft lip), but not for the repair of bilateral III degree cleft lip (first type of bilateral cleft lip). The second method is suitable for the repair of bilateral III degree cleft lip. 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 There are many anesthesia methods for cleft lip surgery, but they can be classified into local anesthesia and general anesthesia. Larger children and adults can undergo surgery under local anesthesia; general anesthesia is used in infants and young children. At this time, it should be based on safety and ensuring the smoothness of the respiratory tract. In recent years, -hydroxybutyrate and thiopental sodium have been used as basic anesthesia, and anesthesia with axillary nerve block or ketamine plus sacral nerve block anesthesia has achieved good results. Surgery can also be performed under general anesthesia with an endotracheal intubation (via an oral cannula). complication In addition to the common complications of unilateral cleft lip and bilateral cleft lip, the main complications of the Millard's bilateral cleft lip repair are more serious. In younger cases, it can lead to severe lip and nasal progression. Malformation, postoperative wound rupture or perforation is not uncommon; when used in adult cases, although it does not cause serious secondary deformities, complications such as wound splitting or perforation may occur. There may be deformities such as anterior labial tissue necrosis and thin red lip tissue in the lower lip of the anterior lip.