Narayan Nitisha, Kapoor Suhavi, Cobb Alistair, McLean Neil, David David, Chummun Shaheel
Southwest Cleft Service, Bristol Dental Hospital, Lower Mauldin Street, Bristol, United Kingdom.
The Cleft Collective, Bristol Dental School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, United Kingdom.
JPRAS Open. 2024 Dec 5;43:377-383. doi: 10.1016/j.jpra.2024.12.003. eCollection 2025 Mar.
Post-operative infection following cleft palate repair can lead to wound dehiscence and subsequent fistula formation. To prevent this, many surgeons advocate using post-operative antibiotic prophylaxis. The use of antibiotics in children is not without risks and with limited published data and variability both countrywide and in our unit, we wanted to address this research question.
To assess fistula rates and whether the provision of antibiotics post-operatively affected the incidence of oronasal fistula formation in patients with cleft palate.
We performed an institutional retrospective study using data from patients undergoing primary palatoplasty between August 2021 and August 2022. These patients were divided into 2 groups. Group A included patients who received antibiotics only on induction and Group B additionally received post-operative antibiotic prophylaxis for 7 days. All participants (97) were evaluated for incidence of post-operative fistula formation.
There was no evidence to suggest a difference in the fistula rate between the different timings of antibiotic regimen in Cycle 1; on induction + 2 intravenous doses (Group A) P = 0.807 and 7 days post-operatively (Group B) P = 0.820. Also, in cycle 2 there was no difference in the fistula rates between the 2 groups; P = 0.546 for Group A and P = 0.571 for Group B.
Our study suggests that the use of antibiotics post-operatively does not influence the formation of post-operative fistulae in cleft palate. This calls for a national randomised controlled study to answer this research question and achieve standardisation of practice.
腭裂修复术后感染可导致伤口裂开及随后的瘘管形成。为预防此情况，许多外科医生主张术后使用抗生素预防。在儿童中使用抗生素并非没有风险，且全国范围内以及我们科室已发表的数据有限且存在差异，我们希望解决这个研究问题。
评估瘘管发生率以及术后使用抗生素是否会影响腭裂患者口鼻瘘的形成发生率。
我们进行了一项机构回顾性研究，使用2021年8月至2022年8月期间接受初次腭裂修复术患者的数据。这些患者被分为两组。A组包括仅在诱导时接受抗生素治疗的患者，B组额外接受7天的术后抗生素预防。对所有参与者（97名）进行术后瘘管形成发生率的评估。
没有证据表明在第1周期不同抗生素治疗时间的瘘管发生率存在差异；诱导时 + 2次静脉给药（A组）P = 0.807，术后7天（B组）P = 0.820。此外，在第2周期两组之间的瘘管发生率也没有差异；A组P = 0.546，B组P = 0.571。
我们的研究表明，术后使用抗生素不会影响腭裂术后瘘管的形成。这需要进行一项全国性随机对照研究来回答这个研究问题并实现实践标准化。
