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[Multilayer repair of palatal fistula with an interpositional collagen matrix]
V Alonso Arroyo1, A Sánchez Abuín1, O D Gómez Beltrán1
1Hospital Clínico Universitario de Valladolid.
Insights
This study introduces a multi-layer repair technique for palatal fistulas, utilizing a collagen graft. This effective method successfully prevented fistula recurrence in two pediatric patients.
Area of Science:
- Plastic Surgery
- Craniofacial Surgery
- Pediatric Surgery
Background:
- Palatal fistulas occur in 7.7-35% of patients following cleft palate repair.
- Previous repairs using the Furlow technique were unsuccessful in two patients, necessitating reintervention.
Observation:
- Two pediatric patients with recurrent palatal fistulas (Pittsburgh type III and V) were treated.
- A multi-layer repair technique was employed, incorporating a local rotational flap and a collagen matrix graft.
Findings:
- The collagen matrix was placed between the nasal and oral layers, with sutures reinforced by a fibrin hemostatic adhesive.
- Both patients achieved successful fistula closure with no recurrence after a 2-year follow-up period.
Implications:
- This three-layer closure technique is a simple, safe, and effective method for treating palatal fistulas.
- Resorbable collagen membranes act as a scaffold, promoting tissue regeneration and mucosal healing, thus avoiding refistulization.
Objective:
Palatal fistula after the repair of cleft palate appears in 7.7-35% of patients. We present two cases of palatal fistula, detailing a multi-layer repair with an interpositional collagen graft.
Material And Methods:
Patient 1: girl with a cleft palate operated using a Furlow technique. A reintervention was performed due to a Pittsburgh type III fistula. Patient 2: male with cleft palate operated using a Furlow technique. A reintervention was performed due to a type V fistula.
Results:
We used a multilayer repair with a local rotational flap and the interposition of a collagen matrix between the nasal and oral layers. The suture was reinforced with a fibrin hemostatic adhesive. No recurrence of the fistula after 2 years.
Conclusions:
The three-layer closure is simple, safe, effective and avoids refistulizations. Interpositional grafts of a resorbable collagen membrane provide a "scaffold" for tissue growth, revascularization and epithelialization of the mucosa.
