Evaluation of Autologous Platelet Rich Fibrin in Cleft Palate Repair

Abstract

Background: Clefts of the lip and/or palate (CLP) are common birth defects of complex etiology. Management of this problem is somehow challenging depending on many factors. The main goal of treatment is mostly functional for the sake of creating normal feeding pattern, acquaintance of normal hearing and hence normal speech development. These goals carry a great impact on social and psychological status of the patient and his family. The repair of cleft palates ideally involves an interdisciplinary team contributing together to achieve this mission. Objective: Evaluation of the role of platelet-rich Fibrin (PRF) on wound healing following primary cleft palate repair. Patients and Methods: It was a prospective study done at the Department of Pediatric Surgery, Al-Azhar University, Cairo, Egypt. A total of forty patients (both sexes) were selected randomly and performed surgery using PRF which was placed during surgical procedure using two flap palatoplasty between the nasal and the oral mucosa. Then, the patients were followed up for six months to evaluate its efficacy in wound healing by monitoring incidence of fistula. All cases in the study group showed complete healing with no fistula or wound dehiscence all over the follow up period except one patient developed oronasal fistula. Results: In this study, post-operative bleeding tendency decreased in patients with preoperative injection of local anesthetic with vasoconstrictor agent and the extent of the surgical field. We measured the amount of bleeding with number of gauzes used by the parents to collect blood from the patients' mouth. Actually, it was blood mixed with saliva in addition to the remaining serum from the PRF. Conclusion: The use of PRF showed satisfying healing for most of the cases under study along the whole follow up period.