Ahmed Owais, Afzal Yusra, Beg Mirza Shehab A, Siddiqui Aimen S, Iqbal Farkhandah M
Plastic and Reconstructive Surgery, Liaquat National Hospital and Medical College, Karachi, PAK.
Plastic Surgery, Liaquat National Hospital, Karachi, PAK.
Cureus. 2021 Dec 28;13(12):e20779. doi: 10.7759/cureus.20779. eCollection 2021 Dec.
Background Cleft lip and palate are common congenital craniofacial anomalies, treated conventionally by surgery at the ages of six to 18 months. Mostly, the interrupted suture technique is used to close the nasal and oral layers of the palate. In some studies, the interrupted suture technique was compared with continuous suture techniques for the closure of oral and nasal layers and found that there was less utilization of time and suture materials in the continuous technique. This study was designed to see the outcomes of interrupted versus continuous suture techniques. Materials & methods A total of 36 patients were included in the study and were divided into two groups according to the type of suturing technique. The time utilized for the repair of the oral and nasal layers of the cleft palate, the number of suture packs utilized, and the incidence of fistula formation were noted and compared between the two groups. Out of 36 patients, 17 were included in group A (operated by interrupted techniques), and 19 were included in group B (operated by the continuous technique). Results The mean time taken to close nasal layer in Group A was 18.12 ± 1.16 minutes and in Group B was 8.37 ± 0.89 minutes (p-value < 0.001), whereas for oral layer closure, it was 14.00 ± 1.17 minutes in group A and 6.00 ± 0.57 minutes in group B (p-value < 0.001). The average usage was 2.26 ± 0.45 suture packs for repair with the continuous technique and 4.00 ± 0.35 suture packs when repaired via interrupted stitches. There was no difference noted in postoperative outcomes in both groups in terms of postoperative fistula and wound dehiscence. Conclusion A continuous suture technique for closing the oral and nasal layers in patients with cleft palate is recommended, as it is more beneficial in terms of time, cost-effectiveness, and utilization of suture material.
唇腭裂是常见的先天性颅面畸形，传统上在6至18个月龄时通过手术治疗。大多数情况下，采用间断缝合技术来关闭腭部的鼻腔和口腔层。在一些研究中，将间断缝合技术与连续缝合技术用于口腔和鼻腔层的关闭进行了比较，发现连续技术在时间和缝合材料的使用上更少。本研究旨在观察间断缝合技术与连续缝合技术的效果。
本研究共纳入36例患者，根据缝合技术类型分为两组。记录并比较两组修复腭裂口腔和鼻腔层所用的时间、使用的缝合包数量以及瘘管形成的发生率。36例患者中，A组17例（采用间断技术手术），B组19例（采用连续技术手术）。
A组关闭鼻腔层的平均时间为18.12±1.16分钟，B组为8.37±0.89分钟（p值<0.001）；而对于口腔层关闭，A组为14.00±1.17分钟，B组为6.00±0.57分钟（p值<0.001）。连续技术修复时平均使用2.26±0.45个缝合包，间断缝合修复时为4.00±0.35个缝合包。两组在术后瘘管和伤口裂开方面的术后结果没有差异。
推荐采用连续缝合技术关闭腭裂患者的口腔和鼻腔层，因为它在时间、成本效益和缝合材料使用方面更具优势。
