Effect of Platelet-Rich Fibrin on Postoperative Complications in Surgical Repair of Secondary Cleft Palate

Document Type : Perspectives

Authors

1 Department of Plastic Surgery, Faculty of Medicine, Helwan University, Cairo, Egypt.

2 Department of Clinical Pathology, Faculty of Medicine, Helwan University, Cairo, Egypt.

3 Department of Plastic Surgery, Sahel Teaching Hospital, Cairo, Egypt.

4 Department of Plastic Surgery, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.

Abstract

Background: Cleft palate is a congenital craniofacial anomaly characterized by the failure of proper fusion of the palatal shelves during embryogenesis. It might seriously affect speech, feeding, and the facial appearance. The latter may cause psychosocial problems. Despite improvement in techniques of surgery, the most serious postoperative complications include formation of oronasal fistula and tissue necrosis.  Platelet-Rich Fibrin [PRF] is an autologous fibrin matrix rich in growth factors that lately has emerged as a promising supplementary approach in the management of cleft palate repair over conventional techniques for enhanced wound healing and lessened complications.
Aim: This study tried to find out the safety and efficacy of PRF when applied to cleft palate surgical repair with regard to post-operative morbidity, the development of fistula, tissue necrosis and functional improvement.
Materials and Methods: A randomized clinical trial was designed with 40 pediatric patients diagnosed with cleft of the secondary palate. They were then divided into two different groups: one with standard repair and one with PRF repair using platelet-rich fibrin. The postoperative complications [e.g., necrosis, fistula formation, and general healing] were duly noted and compared between the two groups.
Results: The incidence of fistula formation and tissue necrosis was significantly less in the PRF group compared to the control group [5.0%, 10.0% vs 30.0% and 35.0%, respectively]. In addition, wound dehiscence was a significantly higher in the control than the PRF group [25.0% vs 5.0]. No statistically significant difference could be found concerning the duration of hospitalization or the total of velopharyngeal function.
Conclusion: PRF application during cleft palate surgery showed great promise in the reduction of postoperative complications with improvement of the overall outcome. 

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