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Effect of collagen matrix on postoperative palatal fistula in cleft palate repair

Palatal fistula is a challenging complication following cleft palate repair. We investigated the usefulness of collagen matrix in the prevention of postoperative fistula. We performed a retrospective cohort study of patients with cleft palate who underwent primary palatoplasty (Furlow’s double oppos...

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Autores principales: Ha, Jeong Hyun, Jeong, Yeonwoo, Koo, Youn Taek, Jeon, Sungmi, Chung, Jeehyeok, Kim, Sukwha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7498452/
https://www.ncbi.nlm.nih.gov/pubmed/32943682
http://dx.doi.org/10.1038/s41598-020-72046-y
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author Ha, Jeong Hyun
Jeong, Yeonwoo
Koo, Youn Taek
Jeon, Sungmi
Chung, Jeehyeok
Kim, Sukwha
author_facet Ha, Jeong Hyun
Jeong, Yeonwoo
Koo, Youn Taek
Jeon, Sungmi
Chung, Jeehyeok
Kim, Sukwha
author_sort Ha, Jeong Hyun
collection PubMed
description Palatal fistula is a challenging complication following cleft palate repair. We investigated the usefulness of collagen matrix in the prevention of postoperative fistula. We performed a retrospective cohort study of patients with cleft palate who underwent primary palatoplasty (Furlow’s double opposing z-plasty) in Seoul National University Children’s Hospital. Collagen Graft and Collagen Membrane (Genoss, Suwon, Republic of Korea) were selectively used in patients who failed complete two-layer closure. The effect of collagen matrix on fistula formation was evaluated according to palatal ratio (cleft width to total palatal width) and cleft width. A total of 244 patients (male, 92 and female, 152; median age, 18 months) were analyzed. The average cleft width was 7.0 mm, and the average palatal ratio was 0.21. The overall fistula rate was 3.6% (9/244). Palatal ratio (p = 0.014) and cleft width (p = 0.004) were independent factors impacting the incidence of postoperative fistula. Receiver operating characteristic curve analysis showed that the cutoff values in terms of screening for developing postoperative fistula were a palatal ratio of 0.285 and a cleft width of 9.25 mm. Among nonsyndromic patients with values above those cutoffs, the rates of fistula development were 0/5, 1/6 (16.7%), and 4/22 (18.2%) for those who received Collagen Graft, Collagen Membrane, and no collagen, respectively. Collagen matrix may serve as an effective tool for the prevention of palatal fistula when complete two-layer closure fails, especially in wide palatal clefts. The benefit was most evident in Collagen Graft with thick and porous structure.
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spelling pubmed-74984522020-09-18 Effect of collagen matrix on postoperative palatal fistula in cleft palate repair Ha, Jeong Hyun Jeong, Yeonwoo Koo, Youn Taek Jeon, Sungmi Chung, Jeehyeok Kim, Sukwha Sci Rep Article Palatal fistula is a challenging complication following cleft palate repair. We investigated the usefulness of collagen matrix in the prevention of postoperative fistula. We performed a retrospective cohort study of patients with cleft palate who underwent primary palatoplasty (Furlow’s double opposing z-plasty) in Seoul National University Children’s Hospital. Collagen Graft and Collagen Membrane (Genoss, Suwon, Republic of Korea) were selectively used in patients who failed complete two-layer closure. The effect of collagen matrix on fistula formation was evaluated according to palatal ratio (cleft width to total palatal width) and cleft width. A total of 244 patients (male, 92 and female, 152; median age, 18 months) were analyzed. The average cleft width was 7.0 mm, and the average palatal ratio was 0.21. The overall fistula rate was 3.6% (9/244). Palatal ratio (p = 0.014) and cleft width (p = 0.004) were independent factors impacting the incidence of postoperative fistula. Receiver operating characteristic curve analysis showed that the cutoff values in terms of screening for developing postoperative fistula were a palatal ratio of 0.285 and a cleft width of 9.25 mm. Among nonsyndromic patients with values above those cutoffs, the rates of fistula development were 0/5, 1/6 (16.7%), and 4/22 (18.2%) for those who received Collagen Graft, Collagen Membrane, and no collagen, respectively. Collagen matrix may serve as an effective tool for the prevention of palatal fistula when complete two-layer closure fails, especially in wide palatal clefts. The benefit was most evident in Collagen Graft with thick and porous structure. Nature Publishing Group UK 2020-09-17 /pmc/articles/PMC7498452/ /pubmed/32943682 http://dx.doi.org/10.1038/s41598-020-72046-y Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Ha, Jeong Hyun
Jeong, Yeonwoo
Koo, Youn Taek
Jeon, Sungmi
Chung, Jeehyeok
Kim, Sukwha
Effect of collagen matrix on postoperative palatal fistula in cleft palate repair
title Effect of collagen matrix on postoperative palatal fistula in cleft palate repair
title_full Effect of collagen matrix on postoperative palatal fistula in cleft palate repair
title_fullStr Effect of collagen matrix on postoperative palatal fistula in cleft palate repair
title_full_unstemmed Effect of collagen matrix on postoperative palatal fistula in cleft palate repair
title_short Effect of collagen matrix on postoperative palatal fistula in cleft palate repair
title_sort effect of collagen matrix on postoperative palatal fistula in cleft palate repair
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7498452/
https://www.ncbi.nlm.nih.gov/pubmed/32943682
http://dx.doi.org/10.1038/s41598-020-72046-y
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