A Prospective Study Investigating Fistula Rate Following Primary Palatoplasty Using Acellular Dermal Matrix

Gilardino, Mirko S.; Aldekhayel, Salah; Govshievich, Alexander

doi:10.1097/gox.0000000000001826

Cited by 16 publications

(18 citation statements)

References 16 publications

(26 reference statements)

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“…Gilardino et al in 2018 in a prospective study conducted on 130 patients undergoing primary palatoplasty stated that the incidence of stula in the study group using ADM was 1.5% versus 12.3% in the control group. The results of this study showed strong evidence of the positive effect of using ADM in the development of stula following primary palatoplasty (25) .…”

Section: Clark Et Al In 2003supporting

confidence: 51%

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The Effect of Acellular Dermal Matrix on the Success of Primary Palatoplasty With Intravelar Veloplasty

Abdali

Hoghooghi

Fattahpour

et al. 2021

Preprint

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BackgroundAcellular Dermal Matrix graft is usually used to repair fistulas following a cleft palate and has had positive results. But its use for primary palatoplasty has been less studied. Our aim was to compare the usefulness of using Acellular Dermal Matrix transplantation for primary palatoplasty with intravelar veloplasty in contrast to its lack of useMaterials and methodsA total of 72 children (6 months to 6 years old) with cleft palate were included in the study. The case-control prospective observations were conducted. A group underwent primary palatoplasty with intravelar veloplasty using Acellular Dermal Matrix and the control group had the same surgery without using Acellular Dermal Matrix. Patients were monitored for fistula formation, post-operative infection, and ulcers.ResultsNo post-surgical infection and wound opening was seen in any group. In the recipients of Acellular Dermal Matrix and control group three and six fistula was reported in which patients had soft and hard palate involvement and the cleft with length greater than 15 mm.ConclusionsConsidering the double incidence of fistulas in the control group compared to the ADM recipient, it seems that the use of ADM can be effective in reducing the incidence of fistulas. Since fistula is one of the complications of primary palatoplasty surgery and leads to secondary surgeries, the use of ADM can be helpful.

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Section: Clark Et Al In 2003supporting

confidence: 51%

“…In addition, in few previous studies generalized results have not been reported due to small sample size. Therefore, there is a need for further studies (25). The present study was designed to investigate the usage and effect of alloderm in the early stages of palatoplasty.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Acellular Dermal Matrix on the Success of Primary Palatoplasty With Intravelar Veloplasty

Abdali

Hoghooghi

Fattahpour

et al. 2021

Preprint

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show abstract

“…This consists of (1) relaxing incisions, (2) a complete intravelar veloplasty, (3) “total release” of the tensor aponeurosis at the level of the hamulus, and (4) circumferential dissection and controlled stretching of the greater palatine neurovascular bundle. Based on a recent prospective clinical trial (Gilardino et al, 2018), there is a clinically significant reduction in fistula formation with the routine use of ADM in primary cleft palate repairs.…”

Section: Discussionmentioning

confidence: 99%

The Use of Acellular Dermal Matrix in Combination With Pedicled Buccal Fat Pad in Wide Cleft Palate Repair: A Case Report and Literature Review

Goh

Chia

2019

The Cleft Palate Craniofacial Journal

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We describe a case of the combined use of acellular dermal matrix and pedicled buccal fat pad (BFP) in a wide U-shaped cleft palate repair. Acellular dermal matrix was used as a “patch” repair for the nasal mucosa defect as opposed to the conventional inlay graft. The advantages include reduced cost and a smaller avascular graft load. Lateral relaxing incisions were made to ensure tension-free closure of oromucosa at midline. Lateral oromucosa defect closure with well-vascularized pedicled BFP ensures enhanced healing, less palatal contracture and shortening, and reduced infection. The palate healed with mucosalization at 2 weeks, and no complications were noted at 6 months follow-up.

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“…That local pathogen-related infections may be partly responsible for oronasal fistulae formation supports the former. Other reported methods to protect the palate post-repair include applying acrylic obturators (Bowers and Gruber, 1973) or reinforcing the repair with acellular dermal matrix (Losee and Smith, 2011;Gilardino et al, 2018).…”

Section: Adjunctive Measuresmentioning

confidence: 99%

Oral Flora and Perioperative Antimicrobial Interventions in Cleft Palate Surgery: A Review of the Literature

Pfaff

Musavi

Wang

et al. 2020

The Cleft Palate Craniofacial Journal

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Background: The role of perioperative antibiotics in cleft palate remains a topic of debate. Advocates stress their importance in preventing local and systemic infections and decreasing the incidence of oronasal fistula formation. However, few studies to date have directly evaluated the role of antibiotics and other antimicrobial measures in cleft palate surgery. Objective: The aim of this review is to evaluate the evidence surrounding the use of perioperative antibiotics and other antimicrobial interventions in cleft palate surgery. Additionally, we review the literature on the oral flora unique to the cleft palate patient population. Methods: This was accomplished utilizing PubMed, Medline, and the Cochrane Library with MeSH and generic terms. Articles were selected based on predefined inclusion and exclusion criteria. Results: This review highlights the lack of higher level evidence on perioperative antibiotic use and other antimicrobial interventions in cleft palatoplasty and calls for further research on the matter. Conclusions: The literature appears to support the use of preoperative antibiotics for cleft palatoplasty, but the benefits of prolonged postoperative antibiotic use remain questionable.

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A Prospective Study Investigating Fistula Rate Following Primary Palatoplasty Using Acellular Dermal Matrix

Abstract: Supplemental Digital Content is available in the text.

Cited by 16 publications

References 16 publications

The Effect of Acellular Dermal Matrix on the Success of Primary Palatoplasty With Intravelar Veloplasty

The Effect of Acellular Dermal Matrix on the Success of Primary Palatoplasty With Intravelar Veloplasty

The Use of Acellular Dermal Matrix in Combination With Pedicled Buccal Fat Pad in Wide Cleft Palate Repair: A Case Report and Literature Review

Oral Flora and Perioperative Antimicrobial Interventions in Cleft Palate Surgery: A Review of the Literature

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