Cleft Lip and Palate : Introduction

Boo-Chai (1966) reported a case of successful closure of a cleft lip at approximately 390 A.D. in China, although the surgeon's name is not mentioned. Yperman (1295-1351) was a Flemish surgeon who appears to have written the first fully documented description of cleft lip and its surgical repair. He closed the freshened borders of the cleft lip with a triangular needle armed with a twisted wax suture, a common method of suture at the time. In order to approximate the internal and external wound edges, he reinforced the closure with a long needle passed through the lip some distance from the edges of the cleft; the needle was held in place by a wraparound ligature-of-eight thread. A similar technique of lip closure was still being performed by Pancoast in 1844.