@article{oai:showa.repo.nii.ac.jp:00000473,
 author = {TOSA, Nozomi and TOSA, Yasuyoshi and YOSHIMOTO, Shinya and NAKANO, Haruhisa and MANDRANO, Nirina Adrien Jean Vivier and KUROKI, Tomoaki and MAKI, Koutaro and KADOMATSU, Koichi},
 issue = {2},
 journal = {The Showa University journal of medical sciences},
 month = {2018-06, 2019-07-26},
 note = {We have been conducting medical collaboration programs for cleft lip and palate in the Republic of Madagascar for seven years, from 2011 to 2017. The purpose of this study was to investigate the incidence of fistula after primary palatoplasty in the Republic of Madagascar, which is a developing country. A further objective was to determine if the group of patients in Madagascar had an increased incidence of palatal fistula compared to a similar group of patients in Japan, and to examine the factors that might be involved in any increase. We conducted a survey of the cleft type, age at time of surgery, and fistula incidence in 44 patients （28 males and 16 females） in Madagascar. The age at the time of surgery was 11 months to 29 years （average, 7 years and 8 months）, and the cleft types were 0 class ?, 14 class ?, 18 class ?, and 12 class ?, by the Veau classifi?cation. We used a modified two-flap palatoplasty for palatal closure. In addition to the selection of surgical technique, the factors which are suggested to influence the incidence of fistula include the experience of the surgeon, and the extent of the cleft. The incidence of postoperative fistula complication in these patients was zero. In medical collaboration settings in developing countries, there are factors which may delay wound healing, such as poor oral hygiene, poor nutrition, and instability of the flap blood flow. Understanding such factors in surgery is important to avoid palatal fistula. We report that a palatal fistula incidence rate of 0% can be achieved by avoiding those factors which contribute to fistula formation.},
 pages = {271--283},
 title = {Incidence and Contributing Factors for Palatal Fistula after Primary Palatoplasty in a Medical Collaboration Program in Madagascar},
 volume = {30},
 year = {}
}