Administration Of Single-dose Antibiotics Does Not Decrease Oronasal Fistula Rates After Primary Palatoplasty
Ishwarya Shradha Mamidi, B.S, Esperanza Mantilla-Rivas, M.D, Brynne A. Ichiuji, B.A., Md Sohel Rana, M.B.B.S., M.P.H., Jason Stein, B.S, Marudeen Aivaz, B.S, Monica Manrique, M.D., Jennifer McGrath, M.D, Gary F. Rogers, M.D., J.D., LL.M., M.B.A., M.P.H, Albert K. Oh, M.D.
Children’s National Hospital, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
PURPOSE: Oronasal fistula (ONF) is a known complication after primary palatoplasty (PP). Most studies investigating the effect of perioperative antibiotics on fistula rates after PP have been limited by relative small numbers or reliance on self-reporting through national databases. In this study, the authors evaluated a large number of consecutive patients undergoing PP by two experienced full-time pediatric plastic surgeons at a single institution to evaluate if perioperative antibiotics decrease postoperative fistula rates.
METHODS: The authors examined their ongoing prospective database of patients who underwent PP between April 2009 and September 2019. Patients were classified into two groups. Group 1 had a single intraoperative dose of IV antibiotic, while Group 2 did not. Outcome measures included length of stay (LOS), ONF formation, and 30-day readmission rates. Multivariable logistic regression was performed.
RESULTS: In the 431 consecutive patients (Group 1 n=217; Group 2 n=214) evaluated, ONF rates for Group 1 and 2 were 3.23% and 0.93% respectively (p=0.12). After adjusting for confounding variables, the rate of ONF between the two groups was not statistically significant (Adjusted Odds Ratio: 0.47; 95% CI: 0.2 - 2.0; p= 0.80). Multivariable linear regression analysis demonstrated no differences in LOS (p=0.97) and readmission within 30 days between the two cohorts (p= 1).
CONCLUSION: Administration of a single-dose perioperative antibiotic did not affect fistula formation after PP. In addition, no significant effect was demonstrated on LOS and 30-day readmission. Based on these data, use of single-dose perioperative antibiotic for PP does not appear to reduce fistula rates.
Back to 2020 Posters
