Platelet Rich Products in Cleft Palate Repair

Objective Cleft palate (CP) is a common congenital malformation with numerous popular and effective techniques described for operative repair. Despite this, the fistula rate following primary as well as secondary palate repairs remains high with reports ranging between 15% and 55% fistula rate. We conducted a systematic meta-analysis review to evaluate the effect of platelet rich products (PRPs) on rate of fistula formation given its well documented association with accelerated wound healing. Design Meta-analysis systematic review. Setting Articles identified through MEDLINE, Embase, Pubmed, Google Scholar, Web of Science, Scopus, Cochrane, References, related articles. Patients, Participants Patients in randomized controlled trials undergoing primary or secondary CP repair. Interventions PRP vs no PRP. Main Outcome Measure Rate of fistula formation. Results Five articles with a total of 164 patients were identified and included in our final meta-analysis. There were 82 patients in each experimental and control groups. A total 22 patients experienced a fistula. Fistula rates in PRP and non-PRP groups were 4.9% (n = 4) and 22.0% (n = 18). The difference of fistula rates between PRP and non-PRP groups was statistically significant (pooled risk ratio: 0.32 (0.12—0.82, p = .02) on our overall pooled meta-analysis. Conclusion In our meta-analysis review, PRP was found to significantly reduce fistula rates after primary or secondary palatoplasty in CP repair. PRP may represent an effective intra-operative adjunct to conventional surgical management and repair of CP to reduce the risk of fistula formation. Further investigation is required to explore the impact of the use of PRP on other post-operative parameters for CP.