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oral and maxillofacial surgery
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ACHMAD MAULUDIN
Pembimbing :
DR. NUSKAH SUDJANA, Drg., SpBM(K)
Introduction
Treatment planning in cleft lip and palate rehabilitation is contingent upon understanding the natural history of the palatal cleft defect and the face in which it exists.
Orofacial cleft are produced by incompletely understood mechanisms, both genetic and environmental
Normal anatomy The elements of the normal lips are composed of the central
philtrum, demarcated laterally by philtrum collums, inferiorly by cupid’s bow and tubercle
Above the junction of vermilion cutaneous border is a mucocutaneous ridge / white skin roll
Within the red vermilion of the lip is a junction demarcating the dry and wet vermillion
Anatomy The primary muscle of the lip : orbicularis oris
Arterial Blood Supply
Normal
Cleft Lip
Nerve InnervationsSensory nerve
Motoric nerve
The Z-PlastyPrinciples
Z-plasty is a plastic surgery technique that is used to improve the functional and cosmetic appearance of defects or scars.
With this technique it is possible to redirect a defect into better alignment with a natural skin fold or the lines of least skin tension.
Z-plasty involves the creation of two triangular flaps of equal dimension that are then transposed.
Z Plasty Procedures The basic 60-degree z-plasty technique
to the lines of least skin tension. The defect length (AB) is 2.5 cm.
Tension on the wound healing eventually widens and thickens the scar.
Incisions are made vertically through the skin using a no. 11 scalpel blade.
The triangular flaps and the surrounding skin are undermined. When tip F is pulled toward C, and tip E toward D, the flaps E and F are transposed.
A few anchoring stitches are placed in the new centerline. The two flap tips are then approximated using interrupted
Additional simple interrupted sutures are placed to close the diagonal lines.
Z-PLASTY, ANGLES, AND THEORETICAL GAIN
Complications of Z-Plasty
flap necrosis, hematoma, wound infection, sloughing of the flap caused by high
wound tension, and the trapdoor effect (elevation of
central tissue resulting from a downward contraction of a surrounding scar).
Z-Plasty Technique Applied
Orbicularis Muscle Management
CONCLUSION
Z-plasty is a plastic surgery technique that is used to improve the functional and cosmetic appearance of defects or scars.
Routine wound care instructions are given to the patient, and prophylactic antibiotics may be considered for use in patients with diabetes and in other immunocompromised patients.
Thank You