Effect of autologous platelet concentrates on healing outcomes in primary cleft repair: a systematic review and meta-analysis of randomized controlled trials
In brief
Five small trials suggest platelet concentrates reduce palatal fistulas by 79%
In five randomized trials involving 168 patients, palatal fistulas were less likely after cleft repair with autologous platelet concentrates, with an estimated 79% reduction compared with repair without them. The evidence was rated very low certainty, so the apparent benefit is not enough to guide practice; larger trials are needed to confirm it.
- Journal
- International journal of oral and maxillofacial surgery (Q1)
- Published
- 2 November 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- H P Siddiqui, S Angel L, K Sennimalai, A Kaur, M Selvaraj
- PMID
- 42971877
- DOI
- 10.1016/j.ijom.2026.10.016
Why clinicians should know about it
- Picked for Plastic and Reconstructive Surgery (paper of the day, 4 November 2026): RCT meta-analysis evaluates fistula prevention in primary cleft repair
Abstract
Autologous platelet concentrates (APCs) are generally thought to decrease the postoperative burden in primary cleft care. The aim of this review was to investigate the incidence of post-surgical palatal fistula and wound dehiscence, and whether APCs used during primary cleft repair can reduce their likelihood. PubMed, Scopus, Web of Science, Ovid (MEDLINE/Embase), EBSCOhost, LILACS, ClinicalTrials.gov, and Cochrane CENTRAL were searched up until December 31, 2025 for randomized controlled trials involving non-syndromic patients, in which APCs were employed during primary cleft lip and/or palate repair. Risk of bias was assessed using the Cochrane RoB 2 tool. A random-effects meta-analysis was conducted for quantitative synthesis; the GRADE framework was used to evaluate the certainty of the evidence. The search retrieved 204 articles, of which five met the inclusion criteria. These studies included 168 patients: 84 who received APCs during primary palatal repair (experimental group) and 84 who underwent primary palatal repair without APCs (control group). The experimental group demonstrated a significantly lower likelihood of developing a palatal fistula compared to the control group (risk ratio 0.21, 95% confidence interval 0.06-0.70, P = 0.01 ; χ2 = 0.92, I2 = 0%). While this finding suggests a potentially beneficial effect of APCs in reducing the risk of palatal fistula, the results should be interpreted with caution, as the certainty of evidence from the included studies was very low. Trial sequential analysis indicated that more studies are required to draw definitive conclusions and make clinical recommendations for the use of APCs in primary cleft repair.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.