Predictors and Outcomes of Delayed Wound Healing Following Modified Sommerlad-Furlow Repair: An Analysis of 1355 Consecutive Cases.

Abstract

This study aims to evaluate the healing process and identify risk factors associated with delayed healing and outcomes. 1355 consecutive participants with nonsyndromic cleft palate, treated with the Sommerlad-Furlow modified palatoplasty. Sixteen variables were recorded including sex, age, cleft type (Veau class), surgeons' qualification, antibiotics, relaxing incision (RI), postoperative upper respiratory tract infection (PURI), preoperative leukocyte count, preoperative hemoglobin (HGB), the cleft width, inter maxillary tuberosity width, the cleft ratio, operation duration, the initial time of poor healing wound observed after surgery, depth and location of the poor healing wound. In total, 1148 patients demonstrated normal healing (84.7%, 1148/1355), while 207 patients exhibited delayed wound healing issues (15.3%, 207/1355), among whom 131 healed within 3 months (9.7%, 131/1355; 63.3%, 131/207), 15 healed after 3 months and within 6 months (1.1%, 15/1355; 7.2%, 15/207), and fistula remained after 6 months in 61 patients (4.5%, 61/1355; 29.5%, 61/207). A total of 1294 (95.5%, 1294/1355) of the participants had healed palatal wounds after 6 months postoperatively. Surgeons' qualifications, PURI, the cleft width, cleft ratio, and operation duration were significantly different in the delayed healing group. Preoperative measurement of the cleft ratio might help the cleft surgeons to predict the palate healing outcome. Surgeons' improved operation skills, shortened operation duration, and prevention of PURI were supposed to reduce the occurrence of poor wound healing. Moreover, focusing on delayed wound depth and location is critical for estimating the process and outcomes of delayed healing.