Nigel Mercer

The arterial basis of pharyngeal flaps is unknown. Injection and dissection studies have been used in 41 adult human cadavers to study the arterial supply of pharyngoplasties in current use. Superiorly based posterior pharyngeal flaps are "random" in nature, inferiorly based posterior pharyngeal flaps may include an "axial" vessel, laterally based posterior pharyngeal flaps will include an "axial" vessel, and laterally based "sphincter" pharyngoplasties, although supplied segmentally, will contain an "axial" vessel if raised up to but not beyond the upper pole of the tonsil.

The purpose of this study was to compare the infection and hypertrophic scar rates in unilateral cleft lip repairs, having had Steri-Strips or Dermabond tissue glue applied across the repair as the final stage. Retrospective study over 13 years of 307 unilateral cleft lip repairs by a single surgeon. The application of either Steri-Strips from 1992 to 1998 (121 patients) or Dermabond tissue adhesive from 1998 to 2006 (186 patients) was used in the final stage of the repair. Regional Centre for Cleft Lip and Palate Care, South West of England. 307 consecutive unilateral cleft lip patients seen from 1992 to 2006. There were five (4%) infections in the Steri-Strip group. All infections were with Staphylococcus aureus. No infections occurred in the Dermabond group (p< .001). There were 15 (12%) hypertrophic scars in the Steri-Strip group and 33 (18%) hypertrophic scars in the Dermabond group (p= .142). Revision surgery was required in a total of seven (6%) patients in the Steri-Strip group. No revisions were required in the Dermabond group (p. 1). We found a lower infection and revision rate and a similar hypertrophic scar rate when Dermabond was used instead of Steri-Strips in the final stage of unilateral cleft lip repair and suggest this study further supports the use of octyl-2-cyanoacrylate tissue adhesive in unilateral cleft lip repair.