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Year : 2023  |  Volume : 10  |  Issue : 1  |  Page : 45-47

Dermal substitute reinforced single-layer closure of the palatal fistula

Department of Plastic, Reconstructive and Aesthetic Surgery, Medanta – The Medicity, Gurgaon, Haryana, India

Correspondence Address:
Dr. Hardeep Singh
Department of Plastic, Reconstructive and Aesthetic Surgery, Medanta – The Medicity, Sector 38, NCR, Gurgaon - 122 001, Haryana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jclpca.jclpca_29_22

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Postoperative palatal fistulas are common after surgery to correct a cleft palate. The repair is hindered by palatoplasty-related scar tissue, reduced vascularity, and restricted mobility of flaps. Surgical repair of fistulae is often effective, but recurrence is common. A 3.5-year-old boy presented with anterior palatal fistula. The presence of peri-fistulous scarring prevented two-layered closure. Nasal layer closure was achieved but not the oral layer. The dermal matrix was reinforced in a one-step procedure over the nasal layer and fixed in place using a gel foam. At 6 months, the fistula almost completely healed, with only a pinpoint track remaining that occasionally leaked into the nasal cavity. These results indicate that the application of dermal matrix is a promising technique to repair fistula with surrounding scarring, but larger, prospective trials are needed to confirm its potential benefits.

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