Department of Plastic Surgery, King Saud University, College of Medicine, Riyadh, Saudi Arabia.
Department of Surgery, King Faisal Specialist Hospital, Riyadh, Saudi Arabia.
J Pak Med Assoc. 2022 Feb;72(2):337-341. doi: 10.47391/JPMA.20-581.
Different cleft palate repair techniques have been described to achieve optimum results and minimise complications. Postoperative fistulae are one of the most challenging complications after palate repair. In this clinical study, we reviewed the records of patients who underwent palatoplasty using acellular dermal matrix (ADM) as an addition to facilitate difficult cleft palate and palatal fistula closure. It was a retrospective, comparative, single-centre study, in which records of patients who underwent cleft palate surgeries between 2015 and 2018 were reviewed. Patients who underwent cleft palate or palatal fistula repair with and without ADM were included. Fischer's exact test was used to compare the two groups (primary cleft palate repair with and without ADM) in relation to the rate of fistula occurrence postoperatively. Charts of a total of 31 patients were reviewed. ADM was used in 13 patients; 8(61.5%) were primary repairs and 5(38.5%) were fistula repairs. Eighteen patients were repaired without ADM, of whom 16(88.9%) were primary cleft palate repairs and 2(11.1%) were fistula repairs. The statistical analysis showed no significant difference in fistula formation rate or recurrence in both the groups. ADM is a simple, safe, and helpful tool for augmenting cleft palate repair, mainly in relatively wide and high-tension cleft palate repairs. In our study, a trend showing decreased complications with ADM was observed. Therefore, we recommend a multi-centre study with a larger sample to assess the significance of ADM in cleft palate and palatal fistulae repair.
不同的腭裂修复技术已经被描述过，以达到最佳效果并最小化并发症。术后瘘管是腭裂修复后最具挑战性的并发症之一。在这项临床研究中，我们回顾了使用脱细胞真皮基质（ADM）作为辅助手段来修复困难的腭裂和腭裂瘘的患者的记录。这是一项回顾性、对比性、单中心研究，其中回顾了 2015 年至 2018 年间接受腭裂手术的患者记录。包括接受腭裂或腭裂瘘修复且使用和不使用 ADM 的患者。Fisher 确切检验用于比较两组（使用和不使用 ADM 的原发性腭裂修复）术后瘘管发生率。共回顾了 31 名患者的图表。13 名患者使用了 ADM；8 名（61.5%）为原发性修复，5 名（38.5%）为瘘管修复。18 名患者未使用 ADM 修复，其中 16 名（88.9%）为原发性腭裂修复，2 名（11.1%）为瘘管修复。统计分析显示两组在瘘管形成率或复发率方面没有显著差异。ADM 是一种简单、安全、有助于修复腭裂的工具，主要用于相对较宽和高张力的腭裂修复。在我们的研究中，观察到使用 ADM 后并发症减少的趋势。因此，我们建议进行一项多中心研究，纳入更大的样本，以评估 ADM 在腭裂和腭裂瘘修复中的意义。
