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Contacts with these participating organizations 2. Tennison or Triangular flap method.
are made months before the actual mission to give Although more exact measurements have
ample time for preparations to be made. At present, to be done, this method has given us
for example, we already have monthly schedules consistently good results. This is
for surgical missions up to October this year. especially true in case where the superior
rotation from the horizontal plane of the
cupids bow is severe. It can be rightly
OPERATING ROOM PROCEDURES: argued that the low triangular flap used
in this method makes for an obvious lip
Our procedures at the OR remain standard scar. However, we feel that in young
except for some modifications adapted for other children below the age of one, the very
particular situation. An example of this is the two favorable scar maturation makes the scar
bed set up in the OR for faster transit and turnover almost unnoticeable.
of patients. This is particularly helpful if the
procedures are successively done under local anes- 3. Rose-Thomson closure.
thesia. Another example is the OR information
sheet. This paper is placed on the OR wall providing This method used with a Z-plasty modiquick
reference on needed patient information for the fication at the mucosal side have been
anesthesiologist as well as the surgeon, used with satisfactorily results in small
The information sheet provides the patient's
name, age, sex,hemoglabin, blood type, diagnosis,
incomplete
surgery to be done, weight in kg. allowable blood B. For Bilateral Cleft lips:
loss, and remarks for any patient idiosyncracy. The
weight in kg. is particularly helpful beacauseit is used 1. Veau IiI tecnique
for computing local and general anaesthetic dosages
as well as allowable blood loss (14 cc/kg). Patients The need for single stage procedure
are listed in sequence by which they are to be become more compelling in outreach
operated,
work. This method, which we have used
in most of our cases, has the advantage
of being a one stage prcedure giving results
CHEILOPLASTY TECHNIQUES USED: that are cosmetically acceptable.
clefts.
Our cheiloplasty techniques have varied from 2. Two stage procedures.
case to case. Definitely, we have come along way
since the "hare lip pins" of old. Among the numerous In rare instances, we have had to resort
techniques described for cleft lip repair since to 2 stage procedures when the protuding _
Mirault introduced cross flap techniques in 1844, we prexamilla prevents a reasonably tension
have been using the following: free closure, especially when complicated
by malnutrition in the child. We
A. For Unilateral Cleft lips: have used 2 successive Millard I techniques
to close a bilateral
1. Milard I and II good cosmetic results.
This has been
used in about 80% of the
cleft lip with
cases. Being a "sight method " or "cut SEQUENCE OF SURGERY:
as you go technique", the need for exact
measurements wi_ a caliper is not The sequence of doing the surgery has become
necessary making this a convenient routine. It takes about 30 to 45 minutes when done
method when calipers are _navailable or under local anaesthesia (in adults and older children)
when doing several cases in a short period at about an hour if done under general anesthesia
of time. (from intubation to extubation of patient).
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