INFLUENCE OF BLOOD BIOCHEMICAL PARAMETERS ON POSTOPERATIVE COURSE IN CHILDREN WITH UNILATERAL CONGENITAL CONNECTIVE CLEFT OF THE UPPER LIP AND PALATE

Abstract

In children with congenital unilateral combined cleft of the upper lip and palate, the postoperative course is not always smooth. In some cases, it can be complicated by inflammation of the soft tissues in the area of the wound edges, both after cheiloplasty and after uranoplasty. This may be followed by a complete or partial divergence of sutures in the area of intervention. Purpose of the work. To study the effect of biochemical parameters of blood, urine and saliva on the postoperative course in children with unilateral congenital connective cleft of the upper lip and palate after cheiloplasty. Any changes in the adaptive system of the body are always manifested by a complex of shifts affecting various elements of the connective tissue system. According to this, the amount of sialic acids in the serum, which is a product of connective tissue destruction, characterizes the activity of the inflammatory reaction in the body. Materials and methods. The study of serum sialic acid concentrations was conducted in 49 patients aged 3 to 9 months with various forms of congenital cleft lip and palate. According to the results of lip plastic surgery, all examined patients were divided into two groups. The first group (48 patients) was made up of children, as a result of plastic surgery, whose palate was completely restored. The second group of children (4 patients) united people whose course of the postoperative period was complicated by the divergence of the edges of the postoperative wound. Research results. During the study, the value of serum sialic acids fluctuated in a fairly wide range. Thus, the minimum concentration of connective tissue destruction products in the blood serum (110–120 CU) was detected in 3 patients. The maximum values of this indicator (210 Cu) were observed in one patient, and a clear inversely proportional dependence of the results of palate plastic surgery on the initial level of serum sialic acids was revealed. Conclusions. If the concentration of sialic acids in the blood serum decreases to less than 135 CU, we can reduce the amount of intervention to prevent complications. In this case, we perform only cheiloplasty, without periosteoplasty, and plastic surgery of the anterior part of the bottom of the nasal passage. With indicators of 110 cu or less, we should generally postpone surgical intervention (cheiloplasty) until these indicators normalize. Thus, we can use these measures to reduce the number of postoperative complications after cheiloplasty in children with congenital connective unilateral cleft of the upper lip and palate.