title: Risk factors leading to mucoperiosteal flap necrosis after primary palatoplasty in patents with cleft palate.
abstract: BACKGROUND
  Few studies have been published reporting risk factors for flap necrosis after primary palatoplasty in patients with cleft palate. This complication is rare, and the event is a disaster for both the patient and the surgeon. This study was performed to explore the associations between different risk factors and the development of flap necrosis after primary palatoplasty in patients with cleft palate.
  
  
  METHODS
  This is a case-control study. A 20 years retrospective analysis (1994-2015) of patients with nonsyndromic cleft palate was identified from medical records and screening day registries). Demographical and risk factor data were collected using a patient´s report, including information about age at surgery, gender, cleft palate type, and degree of severity. Odds ratios and 95% confident intervals were derived from logistic regression analysis.
  
  
  RESULTS
  All cases with diagnoses of flap necrosis after primary palatoplasty were included in the study (48 patients) and 156 controls were considered. In multivariate analysis, female sex, age (older than 15 years), cleft type (bilateral and incomplete), and severe cleft palate index were associated with significantly increased risk for flap necrosis.
  
  
  CONCLUSIONS
  The findings suggest that female sex, older age, cleft type (bilateral and incomplete), and severe cleft palatal index may be associated with the development of flap necrosis after primary palatoplasty in patients with cleft palate.
authors.affiliation: a School of Medicine, San Martin de Porres University, Faculty of Human Medicine , Lima , Peru.|b Outreach Surgical Center , Lima , Peru.|c ReSurge Int , Sunnyvale , CA , USA.
authors.forename: Percy
authors.initials: P
authors.lastname: Rossell-Perry
authors.affiliation: d Mission Caritas Felices , Lima , Peru.
authors.forename: Olga
authors.initials: O
authors.lastname: Figallo-Hudtwalcker
authors.affiliation: d Mission Caritas Felices , Lima , Peru.
authors.forename: Roberto
authors.initials: R
authors.lastname: Vargas-Chanduvi
authors.affiliation: e San Bartolome Children Hospital , Lima , Peru.
authors.forename: Yvette
authors.initials: Y
authors.lastname: Calderon-Ayvar
authors.affiliation: e San Bartolome Children Hospital , Lima , Peru.
authors.forename: Carolina
authors.initials: C
authors.lastname: Romero-Narvaez
mesh_terms: D000293:Adolescent; D000367:Age Factors; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002972:Cleft Palate / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D009061:Mouth Mucosa / Q000637:transplantation; D015999:Multivariate Analysis; D009336:Necrosis / Q000473:pathology; D010521:Periosteum / Q000098:blood supply / Q000637:transplantation; D019651:Plastic Surgery Procedures / Q000009:adverse effects* / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D018709:Statistics, Nonparametric; D013524:Surgical Flaps / Q000473:pathology* / Q000637:transplantation; D013624:Taiwan; D016896:Treatment Outcome
keywords: Cleft palate; flap necrosis; primary palatoplasty; risk factors