The effect of Acellular Dermal Matrix on the success of primary palatoplasty with intravelar veloplasty

Abstract

Background Acellular 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 use Materials and methods A total of 72 children with cleft palate were included in the study. A prospective case-control observation was conducted. A case 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. Results Postoperative fistula was one of the observed complications in patients with a cleft size greater than 15 mm, in the case group, in 3 out of 24 patients (12.5%) and the control group, in 6 out of 11 patients (54.5%), fistula occurred after surgery. Postoperative infection and wound dehiscence was not observed in any group. Conclusions The nature of the cleft palate and the lack of muscles and structures necessary to repair the palate make fistula formation more likely in patients with a larger cleft palate. Based on the results of this study, the use of an Acellular Dermal Matrix in patients with a cleft greater than 15 mm is significantly effective in reducing fistula formation.