title: Use of a purified collagen membrane to aid closure of palatal fistulae.
abstract: BACKGROUND
  Fistula formation following closure of palatal clefts remains a difficult clinical complication. A significant recurrence rate has also been reported following attempted closure. We present our results of fistula closure augmented with Bio-Gide(®), a purified porcine collagen membrane designed to promote guided tissue regeneration.
  
  
  METHODS
  We reviewed the records of 263 patients operated between 1993 and 2011 for closure of palatal fistula. The patients selected comprised 61 who underwent fistula closure augmented with Bio-Gide and 202 with other techniques in the absence of Bio-Gide. We reviewed the age at surgery, sex, location of fistula, cleft type and outcome. Operation success was defined as an asymptomatic patient along with visible confirmation of closure of the fistula.
  
  
  RESULTS
  The overall fistula closure rate was 75% in the Bio-Gide group and 63% in the non-Bio-Gide group (p = 0.070) and 86% versus 61% in the unilateral cleft palate patients (p = 0.027).
  
  
  CONCLUSIONS
  Bio-Gide has improved the success rate in fistula closure in this study. Using this technique, fistula closure can be performed as a day case procedure and does not need to transgress any original suture lines; an additional advantage is that this procedure does not require harvesting of any autologous tissue to augment the repair.
authors.affiliation: South Thames Cleft Unit, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7ET, UK. Electronic address: duncan.atherton@gstt.nhs.uk.
authors.forename: Duncan D
authors.initials: DD
authors.lastname: Atherton
authors.affiliation: South Thames Cleft Unit, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7ET, UK.
authors.forename: John G
authors.initials: JG
authors.lastname: Boorman
mesh_terms: D001672:Biocompatible Materials / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002972:Cleft Palate / Q000601:surgery*; D003094:Collagen / Q000627:therapeutic use*; D005260:Female; D048091:Guided Tissue Regeneration / Q000379:methods*; D006801:Humans; D008297:Male; D008567:Membranes, Artificial; D016155:Oral Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery / Q000628:therapy; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery / Q000628:therapy; D019651:Plastic Surgery Procedures / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome; D006113:United Kingdom
chemical_list: C106416:Bio-Gide; D001672:Biocompatible Materials; D008567:Membranes, Artificial; D003094:Collagen
keywords: Bio Gide; Cleft; Collagen membrane; Fistula