Placement of an antibiotic oral pack on the hard palate after primary cleft palatoplasty: a randomized controlled trial into the effect on fistula rates

Reddy, Rajgopal R.; Reddy, Srinivas Gosla; Banala, Bhavya; Bronkhorst, Ewald M.; Kummer, Ann W.; Kuijpers-Jagtman, Anne Marie; Bergé, Stefaan

doi:10.1007/s00784-017-2286-9

Cited by 13 publications

(12 citation statements)

References 39 publications

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“…Reddy and colleagues' RCT demonstrated that the use of an antibiotic (Framycetin)-soaked oral pack secured to the hard palate following palatoplasty decreased fistula formation risk ( Reddy et al, 2018). The effects of the intervention may be 2-fold: (1) reducing localized pathogen growth and (2) protecting the repair from mechanical trauma.…”

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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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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“…Thus, when designing novel materials for cranio-maxillofacial tissue engineering, it is highly recommended to add antibacterial properties. The prolonged use of antibiotics before, during, and after performing interventions at these zones is a concerning common practice in the clinical setting [3][4][5][6]. However, in recent decades, the world is becoming aware of the importance of misusing antibiotics, and the consequences it has provoked, like the apparition of multi-resistant bacterial strains.…”

Section: Bio-based Polymersmentioning

confidence: 99%

Antibacterial Bio-Based Polymers for Cranio-Maxillofacial Regeneration Applications

et al. 2020

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Cranio-maxillofacial structure is a region of particular interest in the field of regenerative medicine due to both its anatomical complexity and the numerous abnormalities affecting this area. However, this anatomical complexity is what makes possible the coexistence of different microbial ecosystems in the oral cavity and the maxillofacial region, contributing to the increased risk of bacterial infections. In this regard, different materials have been used for their application in this field. These materials can be obtained from natural and renewable feedstocks, or by synthetic routes with desired mechanical properties, biocompatibility and antimicrobial activity. Hence, in this review, we have focused on bio-based polymers which, by their own nature, by chemical modifications of their structure, or by their combination with other elements, provide a useful antibacterial activity as well as the suitable conditions for cranio-maxillofacial tissue regeneration. This approach has not been reviewed previously, and we have specifically arranged the content of this article according to the resulting material and its corresponding application; we review guided bone regeneration membranes, bone cements and devices and scaffolds for both soft and hard maxillofacial tissue regeneration, including hybrid scaffolds, dental implants, hydrogels and composites.

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“…Palatoplasty is considered to be a clean-contaminated procedure (Agrawal, 2009). Risk of infection after palatoplasty is minimal, ranging from 1% to 2% (Owusu et al, 2013;Paine et al, 2016;Reddy et al, 2017;Brignardello-Peterson, 2018;Jodeh et al, 2019a;Jodeh et al, 2019b;Yang et al, 2020). Some studies have posited that infection is a primary contributor to ONF development (Kilner, 1937;Agrawal, 2009;Brignardello-Peterson, 2018).…”

Section: Introductionmentioning

confidence: 99%

Administration of Single-Dose Antibiotic Does Not Decrease Oronasal Fistula Rates After Primary Palatoplasty

Mamidi

Mantilla-Rivas

Ichiuji

et al. 2021

The Cleft Palate Craniofacial Journal

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Objective: Oronasal fistula (ONF) is a known complication after primary palatoplasty (PP). Studies investigating the effect of perioperative antibiotics on fistula rates after PP are limited by inadequate sample size or reliance on self-reporting through national databases. In this study, the authors evaluated the association between single-dose perioperative antibiotics and postoperative fistula rates after PP at a single institution. Design: A retrospective study. Participants: Children younger than 2 years who underwent PP from April 2009 to September 2019 were included. Interventions: Patients were divided into 2 categories: Group 1 received a single intraoperative dose of IV antibiotic, while group 2 did not. Main Outcome Measure(s): Outcome measures included ONF formation, length of stay (LOS), and 30-day readmission rates. Multivariable firth logistic regression, quantile regression, and χ2 tests were performed. Results: Of the 424 patients, 215 and 209 patients were in groups 1 and 2, respectively. The overall ONF rate was 1.9% among all patients. Patients in group 1 experienced an ONF rate of 3.3%, while patients in group 2 had an ONF rate of 0.5%. After correcting for confounding variables, the difference in ONF rates was not statistically different ( P = .68). Median LOS was 35.7 hours and 35.5 hours ( P = .17), while the rate of readmission within 30 days was 4.7% and 2.4% for group 1 and 2, respectively ( P = .96). Conclusions: Administration of a single-dose perioperative antibiotic did not decrease fistula formation after PP, nor did it affect the patient’s LOS or 30-day readmission rate.

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Placement of an antibiotic oral pack on the hard palate after primary cleft palatoplasty: a randomized controlled trial into the effect on fistula rates

Cited by 13 publications

References 39 publications

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

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

Antibacterial Bio-Based Polymers for Cranio-Maxillofacial Regeneration Applications

Administration of Single-Dose Antibiotic Does Not Decrease Oronasal Fistula Rates After Primary Palatoplasty

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