Editing Lip surgery (section)

== Wedge resection of lesion and primary closure ==

* LA +/- mental nerve block
* Mark lesion with 2-3mm margin. Cross vermilion-cutaneous border at right angles. Taper the cutaneous closure to a point that is likely to prevent dog ears. Don't cross the mento-labial crease (follow the curve, if you have to extend the excision that far). In the upper lip, can follow the alar groove if necessary. The internal mucosal wedge is usually smaller.
* Excise a clean, full-thickness wedge
* Identify the labial arteries and either diathermy or ligate
** To temporise bleeding and aid in identification of bleed points, compress the lip laterally between thumb and index finger on each side
* Close dead space of muscular layer with 4-0 vicryl
* Appose vermillion border with 6-0 - use colour change, hair-bearing skin, texture to help identify the specific point.
* Close buccal mucosa
* Close skin

[[Category:Skin, soft tissue and wounds]]