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Updated: Nov 17, 2025

Author Spotlight: Investigating Wound Healing in Mice Models of Oronasal Fistulas
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Administration of Single-Dose Antibiotic Does Not Decrease Oronasal Fistula Rates After Primary Palatoplasty.

Ishwarya Shradha Mamidi1, Esperanza Mantilla-Rivas1, Brynne A Ichiuji1

  • 1Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington, DC, USA.

The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association
|February 15, 2021
PubMed
Summary
This summary is machine-generated.

A single dose of perioperative antibiotics did not reduce orofacial fistula (ONF) rates after primary palatoplasty (PP). This approach also did not impact length of stay or 30-day readmission rates in pediatric patients.

Keywords:
antibioticsoronasal fistulapalatoplasty

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Area of Science:

  • Pediatric Surgery
  • Otolaryngology
  • Antibiotic Stewardship

Background:

  • Oronasal fistula (ONF) is a complication of primary palatoplasty (PP).
  • Evidence on perioperative antibiotics' effect on ONF rates is limited.
  • Previous studies lacked adequate sample size or relied on national databases.

Purpose of the Study:

  • To evaluate the association between single-dose perioperative antibiotics and postoperative ONF rates.
  • To assess the impact of antibiotics on length of stay (LOS) and 30-day readmission.
  • To provide data from a single institution to clarify antibiotic use in PP.

Main Methods:

  • Retrospective study of pediatric patients (<2 years) undergoing PP.
  • Comparison of patients receiving a single intraoperative IV antibiotic dose versus those who did not.
  • Statistical analysis included Firth logistic regression, quantile regression, and chi-squared tests.

Main Results:

  • Overall ONF rate was 1.9% (3.3% in antibiotic group vs. 0.5% in no-antibiotic group).
  • No statistically significant difference in ONF rates after adjusting for confounders (P = .68).
  • No significant differences in median LOS (35.7 vs. 35.5 hours) or 30-day readmission rates (4.7% vs. 2.4%).

Conclusions:

  • Single-dose perioperative antibiotics do not decrease fistula formation after primary palatoplasty.
  • Antibiotic administration did not affect LOS or 30-day readmission rates.
  • Current findings suggest reconsidering routine single-dose antibiotic use for PP.