The use of acellular dermal matrix in palatoplasty to decrease the rate of postoperative oronasal fistula

Area of Science:

• Craniofacial Surgery
• Regenerative Medicine
• Pediatric Surgery

Background:

• Postoperative fistulae are a significant challenge in cleft palate repair.
• Various surgical techniques aim to optimize outcomes and minimize complications.

Purpose of the Study:

• To evaluate the efficacy of acellular dermal matrix (ADM) as an adjunct in cleft palate repair and palatal fistula closure.
• To compare fistula occurrence rates in patients who underwent repair with and without ADM.

Main Methods:

• Retrospective, comparative, single-centre study of 31 patients (2015-2018).
• Patients underwent cleft palate or fistula repair with or without ADM.
• Fischer's exact test used to compare fistula rates between groups.

Main Results:

• 13 patients received ADM (8 primary, 5 fistula repairs); 18 did not (16 primary, 2 fistula repairs).
• No statistically significant difference in postoperative fistula formation or recurrence rates between groups.
• A trend towards decreased complications was observed with ADM use.

Conclusions:

• Acellular dermal matrix (ADM) is a safe and potentially helpful adjunct for augmenting cleft palate repair, especially in wide or high-tension cases.
• Further multi-centre studies with larger sample sizes are recommended to confirm ADM's significance in cleft palate and fistula repair.