Background: Palatal fistula after primary palate repair is
an annoying problem for both patients and plastic surgeons.
The incidence of fistula depends on the severity of the primary
defect, the technique used for repair and the tension applied
over the wound. Different methods are described for palatal
fistula repair, starting from local mucoperiosteal flaps to free
flaps.
The recurrence rate of fistula after primary repair is about
23%, on the other hand the recurrence rate of fistula after its
repair is higher as 25-33% up to 100%. Fistulas are classified
according to its site and size. PRP is an autologous blood
product, it promotes healing of wounds by its high platelet
concentration and multiple growth factors, and also it decreases
the risk of infection and increases neovascularization. PRP
is used in several clinical applications as in oral maxillofacial,
cardiac and plastic surgery.
Methods: A comparative study was conducted on 20
patients with posterior palatal fistulas, who were divided into
two groups, group A in which PRP was injected with fistula
repair and group B fistula was repaired without PRP injection.
Two flap palatoplasty (9 cases in each group) and Furlow
technique (one case in each group) were used for both groups.
Results: A total of 16 patients were followed-up for
recurrence rate of fistulas, statistical analysis showed that in
group A 25% had a recurrence, while in group B 50% of cases
showed recurrence.
Conclusion: PRP injection with the surgical repair of the
palatal fistula has a role in decreasing the recurrence rate of
the fistula and decreasing the need for further surgical interventions
also, it is an easy, safe procedure and at an economic
price.