Acellular Dermal Graft in Secondary Cleft Lip Deficiencies: Assessment of Results With a Reproducible Quantitative Technique

Abstract

Purpose:Considering the little evidence around acellular dermal graft application in secondary lip reshaping, this study is aimed to quantitatively examine the effect of acellular dermal graft in combination with Z-plasty technique in secondary defects of cleft lip.Methods:In this clinical investigation, patients with secondary unilateral cleft lip deformity were selected. Standard photographs were prepared for each patient. Subsequent to scar revision, submucosal tunneling and Z-plasty, implantable human acellular dermal graft was placed and fixed in submucosal pocket. Quantitative parameters included angle of symmetry , dimension of symmetry (DS), defect height (DH), parallel lines, and lip thickness were measured presurgically and 1 year after treatment. Pre and post-operative pictures were compared and the changes were documented according to the criteria. P value less than 0.05 were considered as significant.Results:Eighteen patients were included in this study. The difference of DS between normal side and cleft side was 3.11.5mm presurgically and 1.1 +/- 1.8mm postsurgically. The change was significant (P value<0.05). The difference between pretreatment and posttreatment measures of DS, DH, and Lip Thickness were 2.75 +/- 4.55, 3.43 +/- 4.82, and 2.66 +/- 3.04mm, respectively. The results were significant (P value<0.05).Conclusions:Based on the results, acellular dermal graft in combination with Z-plasty was able to improve lip deformity in patients with secondary defects of cleft lip. Further studies are recommended regarding the application of this technique in patients with bilateral cleft lip and severe "DH."