Risk factors leading to mucoperiosteal flap necrosis after primary palatoplasty in patents with cleft palate

BACKGROUND: Few studies have been published reporting risk factors for flap necrosis after primary palatoplasty in patients with cleft palate. This complication is rare, and the event is a disaster for both the patient and the surgeon. This study was performed to explore the associations between dif...

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Autores principales: Percy Rossell‐Perry, Olga Figallo-Hudtwalcker, Roberto Vargas-Chanduvi, Yvette Calderon-Ayvar, Carolina Romero-Narváez
Formato: Artículo
Lenguaje:inglés
Publicado: 2017
Materias:
Palatoplasty
Medicine
Odds ratio
Logistic regression
Dentistry
Retrospective cohort study
Complication
Medical record
Surgery
Risk factor
Internal medicine
Adolescent
Age Factors
Child
Child, Preschool
Cleft Palate diagnosis
Cleft Palate surgery
Female
Follow-Up Studies
Graft Rejection epidemiology
Graft Rejection pathology
Humans
Infant
Male
Mouth Mucosa transplantation
Necrosis pathology
Periosteum blood supply
Periosteum transplantation
Retrospective Studies
Risk Factors
Sex Factors
Surgical Flaps pathology
Surgical Flaps transplantation
Taiwan
Multivariate Analysis
Logistic Models
Case-Control Studies
Treatment Outcome
Statistics, Nonparametric
Plastic Surgery Procedures adverse effects
Plastic Surgery Procedures methods
Life Sciences Biochemistry, Genetics and Molecular Biology Genetics Cleft Lip and Palate Research
Health Sciences Medicine Surgery Reconstructive Surgery and Microvascular Techniques
Health Sciences Medicine Public Health, Environmental and Occupational Health HIV/AIDS oral health manifestations
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Sumario:BACKGROUND: Few studies have been published reporting risk factors for flap necrosis after primary palatoplasty in patients with cleft palate. This complication is rare, and the event is a disaster for both the patient and the surgeon. This study was performed to explore the associations between different risk factors and the development of flap necrosis after primary palatoplasty in patients with cleft palate. METHODS: This is a case-control study. A 20 years retrospective analysis (1994-2015) of patients with nonsyndromic cleft palate was identified from medical records and screening day registries). Demographical and risk factor data were collected using a patient´s report, including information about age at surgery, gender, cleft palate type, and degree of severity. Odds ratios and 95% confident intervals were derived from logistic regression analysis. RESULTS: All cases with diagnoses of flap necrosis after primary palatoplasty were included in the study (48 patients) and 156 controls were considered. In multivariate analysis, female sex, age (older than 15 years), cleft type (bilateral and incomplete), and severe cleft palate index were associated with significantly increased risk for flap necrosis. CONCLUSIONS: The findings suggest that female sex, older age, cleft type (bilateral and incomplete), and severe cleft palatal index may be associated with the development of flap necrosis after primary palatoplasty in patients with cleft palate.

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