Olawoye O A, Michael A I, Olusanya A
Department of Surgery, College of Medicine, University of Ibadan, Ibadan.
Department of Plastic, Reconstructive and Aesthetic Surgery, University College Hospital, Ibadan.
Ann Ib Postgrad Med. 2020 Jun;18(1):S51-S57.
Clefts of the primary and secondary palate represent one of the commonest congenital anomaly for which surgical correction is required. The perioperative care of the patients varies widely across centers and among surgeons and range from preoperative swab of palatal clefts for microbiological studies to prophylactic and or therapeutic antibiotic care. These practices have economic implications especially in the Low and Middle Income Countries (LMIC) where the cost of care are borne directly by the parents. The clinical implications of indiscriminate antibiotic use may also include development of resistant strains and hypersensitivity reactions which may be life threatening. Surgical site infections and its possible sequelae of dehiscence and fistulae is another concern for the surgeon and the patient. This review examines the microbiological pathogens, surgeon's perspectives as well as the current evidences for the use of perioperative antibiotic therapy in orofacial cleft surgery and concludes with a need for a large multicenter randomized clinical trial to answer critical aspects of the subject.
原发性和继发性腭裂是最常见的先天性畸形之一，需要进行手术矫正。患者的围手术期护理在不同中心和外科医生之间差异很大，范围从术前对腭裂进行拭子采集以进行微生物学研究到预防性和/或治疗性抗生素护理。这些做法具有经济影响，尤其是在低收入和中等收入国家（LMIC），那里的护理费用直接由父母承担。滥用抗生素的临床影响还可能包括耐药菌株的产生和过敏反应，这可能危及生命。手术部位感染及其可能的裂开和瘘管后遗症是外科医生和患者的另一个担忧。本综述研究了微生物病原体、外科医生的观点以及口腔颌面裂手术围手术期抗生素治疗的现有证据，并得出结论认为需要进行一项大型多中心随机临床试验来回答该主题的关键问题。
