Cleft soft palate reconstruction: prospective study on infection and antibiotics

Abstract

Abstract. The aim of this prospective study was to identify possible pathogenic organisms associated with wound complications in the form of wound infections, wound breakdown and the formation of oro-nasal fistulas. The organisms' resistance profile to antibiotics was also evaluated. This prospective study consisted of the evaluation of the intra-oral microbiological profile of 100 babies with soft palate cleft deformities peri-operatively. A wide spectrum of pathogenic organisms from the upper aero-digestive track was isolated, as well as a group of organisms that originated from the colon/perineum. The latter organisms were mostly associated with postoperative complications. The antibiotic resistance profile showed a high resistance to commonly used antibiotics such as ampicillin, amoxycillin-clavulanic acid, and first-and second-generation cephalosporins. The resistance profile of the organisms needs to be reassessed and appropriate antibiotics must be used in combination with an antimicrobial mouth rinse.

The spectrum of intraoral bacteria seen in patients with cleft palates in an African setting

“…Three studies bear special mention: Adeyemo et al. (), Mÿburgh & Bütow (), and Roode et al. () are studies from Africa and as such could be seen to address similar concerns to ours.…”

“…Mÿburgh & Bütow (), when assessing soft palate clefts alone, performed cultures on days 0, 2, 4 and 6. The most commonly cultured pathogenic organisms on day 0 were (in order of prevalence) Staphylococcus aureus , Klebsiella pneumoniae , Candida albicans and Escherichia coli .…”

A Comparative Study of Oral Microbiota in Infants with Complete Cleft Lip and Palate or Cleft Soft Palate

“…These strains can cause acute infections, particularly in immunodeficient individuals. These inflections include brain, mouth, or liver abscesses and endocarditis, whereas S. agalactiae can cause bacteraemia in neonates, acute pulmonary insufficiency, and cerebrospinal meningitis [20]. In a study of the microbiota in patients with lip cleft prior to surgical intervention, Cocco et al did not detect the presence of group A β -haemolytic streptococci in any of the patients.…”

“…Furthermore, changes in the amount and composition of oral microbiota have been reported in subjects with different types of cleft palate during deciduous or permanent dentition [17] and as the result of surgical or orthodontic treatment [18–20]. …”

Effect of presurgical orthopedics on oral-health related quality of life in Chilean children with cleft lip and palate. A pilot study.

“…3 However, some authors emphasize negative aspects of PSO, such as the complexity of its manufacture, high economic costs, higher rates of postoperative complications, and accumulation of plaque. [3][4][5] Consequently, there is no agreement regarding the use and effectiveness of PSO in children with CLP. 6 The quality of life of children with CLP is an important and integral health indicator, observable in functional and psychosocial outcomes.…”