Funding sources No external funding.
DERMATOLOGICAL SURGERY AND LASERS
Direct primary closure without undermining in the repair of vermilionectomy defects of the lower lip
Article first published online: 29 OCT 2012
DOI: 10.1111/j.1365-2133.2012.11104.x
© 2012 The Authors. BJD © 2012 British Association of Dermatologists
Additional Information
How to Cite
Barry, R.B.M., McKenzie, J., Berg, D. and Langtry, J.A.A. (2012), Direct primary closure without undermining in the repair of vermilionectomy defects of the lower lip. British Journal of Dermatology, 167: 1092–1097. doi: 10.1111/j.1365-2133.2012.11104.x
Conflicts of interest None declared.
R.B.M.B. and J.McK. have contributed equally to this work and should be considered as co-authors. All work was done in either the Dermatology Surgical Unit, Royal Victoria Infirmary, Newcastle upon Tyne, U.K. or in the Dermatologic Surgery Unit, Division of Dermatology, University of Washington, Seattle, WA, U.S.A.
Publication History
- Issue published online: 29 OCT 2012
- Article first published online: 29 OCT 2012
- Accepted manuscript online: 18 JUN 2012 03:13PM EST
- Accepted for publication 11 June 2012
- Abstract
- Article
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Summary Background Vermilionectomy is an excisional technique for the treatment of lower lip squamous cell carcinoma and actinic cheilitis. The vermilionectomy defect is usually repaired by a labial mucosal advancement flap. Traditionally, the mucosal wound margins are widely undermined but this can be associated with significant postoperative morbidity.
Objectives We describe our experience with a modified technique whereby lower lip vermilionectomy defects were repaired by direct primary closure without undermining and present the subsequent cosmetic, functional and sensory results.
Methods and materials This is a retrospective case series of 21 patients who underwent vermilionectomy repair by direct closure without undermining. Combined data regarding the presence of any postoperative sensory, functional or cosmetic disturbance are presented.
Results Complete data were available for 17 patients. Minimal sensory disturbance was noted in 10·5% of our patients 6 months postoperatively, which is less than previous studies. Similarly, labial scar tension was less frequent in our series; 94% of the patients were satisfied with cosmesis.
Conclusions Direct closure without undermining is a simple, reproducible technique for repair of lower lip vermilionectomy defects and leads to excellent cosmetic, functional and sensory results in the majority of patients.

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