The Abbé flap in cleft lip and palate repair

Abstract

The Abbé flap is a procedure where the volume of the upper lip is increased at the expense of the lower lip. This study reviewed the Abbé flaps done at Skåne University Hospital during the years 1991-2006 and identified 14 patients. Data was collected from medical records. Eleven patients were deemed fit for interviews and were called to the hospital by standard mail. Six patients responded and were interviewed, examined, and photographed. One patient was interviewed over the telephone. Median age at surgery was 14 years (range = 6-22). The operation time was 152 minutes (range = 90-215). The Abbé flap was divided after 12 days (range = 11-16). All 14 flaps survived and no complications were noted. Secondary corrections were done in nine patients. Three patients experienced having their lips sutured together as difficult, and four patients described this period as easy. All patients described their lips as having better appearance after the operation and, in three of four cases, where a simultaneous columella lengthening was done, the patients described their noses as having better appearance. The scar on the lower lip was negative but also a prerequisite for the operation. All seven patients said the operation was worth all the effort and would recommend it to patients in similar situations. This data supports that the Abbé flap is a safe technique that effectively improves the appearance of the upper lip and satisfies the cleft lip and palate patients.

Colgajo de Abbé en queiloplastia secundaria, revisión de literatura y presentación de tres casos

“…Los pacientes comienzan con analgésicos líquidos y antibióticos, aunque el uso de pastillas trituradas es otra opción, la vaselina se aplica a las incisiones diariamente hasta la segunda operación, y los casos pueden comenzar la limpieza diaria de las incisiones con peróxido de hidrógeno y agua en una solución 50:50 a partir del día cuatro del postoperatorio. 4,6 La división se realiza a las dos semanas del postoperatorio, inicialmente con anestesia local, puede ir acompañada de una sedación ligera, para evitar una intubación transnasal y con la ventaja de que el paciente se encuentra despierto. Una vez dividida, la arteria labial se liga.…”

“…3 El colgajo, está diseñado con la mitad del ancho del defecto para que la deficiencia de tejido se comparta por igual entre el labio superior e inferior y debe colocarse de manera que el ancho del bermellón del sitio donante coincida con el segmento del labio que se está reemplazando. 1,4 Si se reemplaza una unidad estética discreta, se debe delinear el tamaño exacto correspondiente al del colgajo; la división del colgajo se produce a las dos o tres semanas. 1…”

Cleft Le Fort I Osteotomy

“…For this purpose, various modifications have been presented in the literature such as extended or long Abbe design. [2][3][4] In this study, we used a new composite Abbe flap for repairing of upper lip tightness, columellar lengthening, and alveolar cleft repair in a 23-year-old woman CLN patient (Fig. 1A).…”

A standardized approach to airway management during Abbé flap reconstruction

“…2 Since that time the original technique has been modified and its utility has been expanded to treatment of upper lip and even columellar defects secondary to trauma or tumor excisions. [3][4][5] Insertion of the flap leads to a surgically closed mouth, which remains closed until division of the pedicle during the second stage.…”

“…The second stage involves division and insetting of the pedicle 10 or more days after the initial procedure 2 . Since that time the original technique has been modified and its utility has been expanded to treatment of upper lip and even columellar defects secondary to trauma or tumor excisions 3–5 …”