USE OF TISSUE ADHESIVES FOR CLEFT LIP REPAIR

Cleft lip repair in infants is traditionally completed using non-absorbable sutures such as nylon or polypropylene. This presents the medical and nursing staff with the problem of removing these fine sutures in these children after 5 days. The safety of removing these sutures under sedation, on the ward, has raised concerns as no specific anaesthetic cover is provided for such an activity. The process is also distressing and usually inconvenient for the families involved.

For overcoming this problem, tissue glues (Cyanoacrylate adhesives) are being used instead of skin sutures. They polymerize rapidly within seconds following contact with proteinaceous surfaces to form strong and flexible bonds. This chemical property makes them extensively used in different surgical applications. They have been used for wound closure, skin graft fixation and other surgical applications.

Cyanoacrylate can also be applied to the nasal and/or the oral layer of cleft palate repair cases with friable mucosal edges where an occurrence of fistulae is anticipated. The Cyanoacrylate glue can also be used to retain the haemostatic packs at the lateral releasing incisions of the cleft palate repair cases. Cyanoacrylate can be used for skin closure after suturing the subcutaneous layer in cleft lip cases. They can also be used for skin closure in pediatric facial lacerations. Their use in cleft lip repair can thus eliminate the need for suture removal on the skin surface and prevents the discomfort for the infant and the family.

All types of cleft lip and palate repair procedures, secondary surgeries and speech surgeries, speech therapy and the required dental treatment for cleft patients are being done at Richardson’s dental & craniofacial hospital by Dr.Sunil Richardson & his team.