2018 Volume 43 Issue 1 Pages 6-11
Autologous iliac cancellous bone grafting in the alveolar cleft is used as a general treatment for patients with cleft lip and palate （CLP）. The thickness of the soft tissue and protrusion in the donor site of the ilium may affect the wound tension, which affects healing. In this study, to clarify the factors affecting wound condition, we evaluated the wound condition of the donor site, and investigated the correlation between the wound condition and the Rohrer Index （RI ＝ weight （kg） / height （cm）3 × 107）.
The subjects were 62 patients with CLP who underwent iliac bone grafts in the alveolar cleft （72 sides, mean age 10.6 years） in our department from 2009 to 2016. The oral surgeons evaluated the wound healing using photographs of the donor site three months after the graft. The wounds were classified with a wound healing score from 1 to 5. Scores of 1 or 2 indicated good healing （good wound group）; a score of 4 or 5 indicated poor healing （poor wound group）. We also analyzed the correlation between the wound score and the age, weight, height, and RI of each patient using Pearson’s correlation coefficient. In addition, we compared the values of the good wound and poor wound groups using Student’s t-test. We obtained the following findings:
1．The good wound group included 35-41 （48.6-56.9％） of the 72 sides, and the poor wound group included 19-24 （26.4-33.3％） sides.
2．The mean RI of the good wound group was significantly higher than that of the poor wound group （good RI＝ 125; poor RI＝114; p ＜ 0.05）. Moreover, there was a moderate negative correlation between the wound healing score and the RI. There were no significant differences between other variables.
3．Cases with a low RI may have been due to insufficient subcutaneous tissue at the donor site; suture closure was more difficult and increased skin tension due to increased protrusion of the iliac crest. In conclusion, we suggest that a suture technique that relieves wound tension is necessary for infants with a low RI.
