Abstract：
Reconstruction of lips after squamous cell carcinoma (SCC) removal should restore functional and aesthetic roles; however, it remains a challenge. In this study we describe the clinical features of lip SCC and suggest a reconstruction algorithm. We retrospectively analyzed 34 patients with lip SCC who underwent reconstruction after Mohs micrographic surgery between January 2006 and March 2022. The mean age of the patients was 70.2 years. Seven tumors were on the upper lip and 27 tumors were on the lower lip. Twenty-five defects were located on the mucosal lip, eight defects involved both the mucosal and cutaneous lips, and one defect was confined to the cutaneous lip. Eighteen defects were smaller than 50% of the total lip size, and 16 were larger than 50%. Primary closure was mostly performed for defects smaller than 50% of the lip size (9/18 cases), and local flap, according to the location and size of the defects, was performed for larger defects. Thirteen patients experienced postoperative complications but improved within 1 year after surgery, except for one patient. We suggest a reconstruction algorithm with a 50% cut-off value. Defects smaller than 50% of the lip size could be reconstructed by primary closure. Even larger defects could be reconstructed by creation of a local flap from the remaining adjacent tissue with minimal postoperative complications.
摘要：
鳞状细胞癌（SCC）切除后的嘴唇重建应恢复功能和美学作用；然而，这仍然是一个挑战。在这项研究中，我们描述了嘴唇SCC的临床特征，并提出了一种重建算法。我们回顾性分析了2006年1月至2022年3月在Mohs显微照相手术后接受重建的34例嘴唇SCC患者。患者的平均年龄为70.2岁。7个肿瘤位于上唇，27个肿瘤位于下唇。粘膜唇上有25个缺损，八个缺陷涉及粘膜和皮肤嘴唇，一个缺陷局限于皮肤唇。18个缺陷小于总唇尺寸的50%，16个大于50%。对于小于嘴唇尺寸的50％的缺陷（9/18例），主要进行了初次闭合。和局部皮瓣，根据缺陷的位置和大小，对较大的缺陷执行。13例患者出现术后并发症，但在术后1年内好转，除了一个病人。我们建议一种具有50％截止值的重建算法。可以通过初次闭合来重建小于嘴唇尺寸的50％的缺陷。通过从剩余的邻近组织创建局部皮瓣，可以重建更大的缺损，而术后并发症最少。
