Retrospective Analysis of Sutureless Skin Closure in Cleft Lip Repair

Halli, Rajshekhar; Joshi, Ajit; Kini, Yogesh; Kharkar, Viraj; Hebbale, Manjula

doi:10.1097/scs.0b013e318241db01

Cited by 16 publications

(16 citation statements)

References 14 publications

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“…Two studies found no difference in parental satisfaction whether adhesives or resorbable sutures 8 , or adhesives or non-resorbable sutures were used (Collin et al) 10 . However, Halli et al found parental satisfaction to be higher for infants treated with adhesives as compared with nonresorbable sutures (P = 0.05) 11 . Infection was reported in one study and defined retrospectively by the presence of a positive microbiological swab and antibiotic treatment 12 .…”

Section: Characteristics and Results Of Outcome Measuresmentioning

confidence: 98%

“…The studies compared a range of conventional closure materials. Adhesives were compared with resorbable sutures, non‐resorbable sutures and steri‐strips. One compared resorbable with non‐resorbable sutures.…”

Section: Resultsmentioning

confidence: 99%

“…Adhesives were compared with resorbable , non-resorbable sutures 10,11 and steri-strips 12 . One compared resorbable with non-resorbable sutures 13 .…”

Section: Characteristics Of Interventionsmentioning

confidence: 99%

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A systematic review of skin closure techniques in primary cleft lip surgery

et al. 2014

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Aim: To carry out a systematic review of the published evidence for skin closure techniques in primary cleft lip surgery. Methods: Five electronic databases were searched from their inception to February 2013 to identify all relevant studies of wound closure techniques in primary cleft lip surgery. Two reviewers independently determined eligibility of studies, assessed the methodological quality of the included studies and extracted data. Results: Six eligible studies were included. Five were observational studies so were prone to bias. One was a randomised controlled study. Four compared adhesive with sutures, one compared adhesives with steri-strips and one compared absorbable and non-absorbable sutures. No cases of dehiscence (primary outcome measure) were reported. The methodological quality of all the included studies was poor. Conclusions: There is currently insufficient evidence to guide clinical practice for incision closure in primary cleft lip surgery. Adequately powered randomised controlled trials are required to address this issue. Clinical relevance Scientific rationale for studyClosure of primary cleft lip surgery incisions is carried out using a number of different materials dependent on surgeon preference/experience. A systematic review has shown that adhesives are associated with an increased rate of dehiscence in other surgical sites. The question of which closure material should be used has been identified by a cleft workshop as a top priority. Principal findingsSix studies were identified; all had methodological issues limiting their usefulness. Practical implicationsThere is insufficient evidence to determine the best closure material for primary cleft lip surgery incisions. A large trial is needed to guide practice.

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Section: Characteristics and Results Of Outcome Measuresmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

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A systematic review of skin closure techniques in primary cleft lip surgery

et al. 2014

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“…The plastic surgery and dermatology literature has shown tissue adhesives to produce an equivalent or superior cosmetic outcome than suture in surgical facial wound closure. [46][47][48] In closures and locations where more eversion is needed, such as the nasal bridge, an interrupted or running horizontal mattress suture may be used (Figure 7). 49 In areas of natural concavity, such as the alar crease and scaphoid fossa, wound inversion is preferred and a simple interrupted or inverted horizontal mattress suture is useful.…”

Section: Facementioning

confidence: 99%

Suture Products and Techniques

Regula¹,

Yag-Howard

2015

Dermatologic Surgery

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Numerous factors must be considered when choosing a wound closure material and suturing technique. These include wound tension, desire for wound edge eversion/inversion, desired hemostasis, repair type, patient's ability to care for the wound and return for suture removal, skin integrity, and wound location. Careful consideration of these factors and proper execution of suturing techniques can lead to excellent cosmetic results.

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“…Facial morphology is an important outcome variable of cleft treatment, and various methods for assessment of facial morphology have been described in the literature, including direct physical measurements (Farkas, Hajnik & Poswick, 1993;Reddy et al, 2010), rating of standardized clinical photographs (Chowdri, Darzi & Ashraf, 1990;Halli et al, 2012), as well as sophisticated three-dimensional (3D) imaging techniques (Kuijpers et al, 2014). A systematic review of the literature regarding the reliability and application of 3D facial imaging methods in babies and young children, both unaffected control subjects as well as subjects with OFCs, concluded that stereophotogrammetry is the preferred method due to its millisecond fast image capture, archival capabilities, high resolution, and no exposure to ionizing radiation (Brons et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Peer Review #3 of "Three-dimensional facial development of children with unilateral cleft lip and palate during the first year of life in comparison with normative average faces (v0.1)"

2019

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Background. Stereophotogrammetry can be used to study facial morphology in both healthy individuals as well as subjects with orofacial clefts because it shows good reliability, ability to capture images rapidly, archival capabilities, and high resolution, and does not require ionizing radiation. This study aimed to compare the 3D facial morphology of infants born with unilateral cleft lip and palate (UCLP) with an age-matched normative 3D average face before and after primary closure of the lip and soft palate. Methods. Thirty infants with a non-syndromic complete unilateral cleft lip, alveolus, and palate participated in the study. 3D images were acquired at 3, 6, 9, and 12 months of age. All subjects were treated according to the primary surgical protocol consisting of surgical closure of the lip and the soft palate at 6 months of age. 3D images of UCLP patients at 3, 6 (pre-treatment), 9, and 12 months of age were superimposed on normative datasets of average facial morphology using the children's reference frame. Distance maps of the complete 3D facial surface and the nose, upper lip, chin, forehead, and cheek regions were developed. Results. Assessments of the facial morphology of UCLP and control subjects by using color-distance maps showed large differences in the upper lip region at the location of the cleft defect and an asymmetry at the nostrils at 3 and 6 months of age. At 9 months of age, the labial symmetry was completely restored although the tip of the nose towards the unaffected side showed some remnant asymmetry. At 12 months of age, the symmetry of the nose improved, with only some remnant asymmetry noted on both sides of the nasal tip. At all ages, the mandibular and chin regions of the UCLP patients were 2.5-5 mm posterior to those in the average controls. Conclusion. In patients with UCLP deviations from the normative average 3D facial morphology of agematched control subjects existed for the upper lip, nose, and even the forehead before lip and soft palate closure was performed. Compared to the controls symmetry in the upper lip was restored, and the shape of the upper lip showed less variation after primary lip and soft palate closure. At this early age, retrusion of the soft-tissue mandible and chin, however, seems to be developing already.

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Retrospective Analysis of Sutureless Skin Closure in Cleft Lip Repair

Cited by 16 publications

References 14 publications

A systematic review of skin closure techniques in primary cleft lip surgery

A systematic review of skin closure techniques in primary cleft lip surgery

Suture Products and Techniques

Peer Review #3 of "Three-dimensional facial development of children with unilateral cleft lip and palate during the first year of life in comparison with normative average faces (v0.1)"

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