Page 61 - Read Online

tie, unlikely to break prematurely, and induces minimal Patients in both groups were evaluated for postoperative
inflammatory response. Others feel that these issues are healing, infection rate, disruption of the wound, wound
not important and prefer absorbable sutures because they dehiscence, hypertrophic scar formation, and postoperative
do not have to be removed and thus, decreasing patient’s esthetic outcome. Patients were followed and evaluated
anxiety and discomfort. [4] at 1 month, 6 months, and 1 year. Patient’s photographs
were evaluated by three different people (social worker,
This study aims to compare the cosmetic outcomes and surgeon and patient’s mother) using a validated 100 mm
complications of primary cleft lip repaired with absorbable cosmesis visual analogue scale (VAS). In this study, a VAS
sutures versus nonabsorbable sutures. It also aims to score of 15 mm or greater was considered as a clinically
identify a feasible surgical technique for Indian patients.
significant difference. [5]

METHODS Descriptive statistical analysis was used to compare
demographics and wound characteristics of the study
This study was conducted at the Smile Train Unit of groups. Differences between the groups were analyzed
Department of Cleft and Craniofacial Surgery at Child using variance analysis on rank data. VAS with a clinical
Hospital and Research Institute in Nagpur, India. The difference of 15 mm or less was considered clinically
children’s parents involved in this article agreed to publish significant.
their children’s facial pictures and signed the form. Patients
with cleft lip who presented here from June 2010 to May RESULTS
2012 were selected for this study with the following
inclusion criteria: The average age of the patient was 3 months. There was
1. Patients with unilateral primary cleft lip no significant difference in the rates of infection which
2. Patients with 10 weeks age, 10 gm Hb %, and 10 pounds was 6% in this study, wound dehiscence, hypertrophic
of weight scar formation. There was no significant difference in the
3. Patients physically fit to undergo general anesthesia (GA). rates of infection, wound dehiscence, and hypertrophic
A total of 60 patients who met the criteria were included scar formation. The postoperative wound infection was
treated by oral amoxicillin in both groups [Table 1]. No
in this study, and they were divided into two groups significant difference was found in cosmetic outcome in
randomly: both the groups with mean VAS of 90.3 in Group 1 and
• Group 1: (n = 30) Cleft lip repair was performed using 91.7 in Group 2 [Tables 2–4].
absorbable suture (Vicryl Rapid) [Figure 1].
• Group 2: (n = 30) Cleft lip repair was performed using DISCUSSION
nonabsorbable suture (Prolene) [Figure 2].
All patients underwent routine blood tests, and informed Orofacial clefts are the most common head and neck
consent was obtained from parents prior to surgery. The congenital malformations. Cleft lip and cleft palate have
study was approved by the institution’s Ethical Committee. significant psychological and socioeconomic effects on
All patients underwent standard Millard’s rotational patient and affect their quality of life thus, requiring a
advancement technique by the same surgeon to repair the multidisciplinary approach for management. The complex
cleft lip. Patients were randomized by providing the surgeon interplay between genetics and environmental factors
with a sealed envelope that stated the type of suture to be [1]
used in the procedure before entering the operation theater. plays a significant role in the formation this anomaly.
All patients in Group 2 required GA or sedation for The primary goals of surgical repair are to restore normal
removal of sutures on 7th postoperative day. function for speech development and facial aesthetics.

Figure 1: Preoperative and postoperative photo at 1 month, 6 months, Figure 2: Preoperative and postoperative photo at 1 month, 6 months,
and 1 year follow‑up for Group 1 and 1 year follow‑up for Group 2
Plast Aesthet Res || Vol 1 || Issue 2 || Sep 2014 55