C.7. What is an Abbe flap? What are its anesthetic implications?
Answer:
An Abbe flap is a full-thickness pedicle flap taken from the lower lip and rotated on its own artery to a position in the upper lip to replace a tissue deficit resulting from any cause, such as surgical excision of malignancy or loss of tissue in a bilateral cleft lip. The lips must remain closed until the flap "takes" to allow for neovascularization. Then, it can be detached from its blood supply. Usually, this operation is performed in older children under local anesthesia, but it occasionally requires general anesthesia if the patient is young. All the problems of a closed mouth, such as the possibility of vomiting and aspiration, are encountered in addition to those associated with preservation of the flap.
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