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Ambulatory surgery for cleft lip repair
1University of Massachusetts Medical Center, Division of Plastic and Reconstructive Surgery, Worcester 01655, USA.
Annals of Plastic Surgery
|April 23, 1999
Summary
Ambulatory cleft lip repair is safe and effective, allowing infants to feed sooner and with fewer complications compared to traditional inpatient care. This approach supports early home care by parents.
Area of Science:
- Pediatric Surgery
- Plastic Surgery
- Craniofacial Surgery
Background:
- Standard cleft lip repair involves preadmission testing, surgery, and inpatient postoperative care.
- Ambulatory cleft lip repair aims to facilitate safe, early home care for infants by parents.
- This study retrospectively compares outcomes of ambulatory versus inpatient cleft lip repair.
Purpose of the Study:
- To evaluate the outcomes of ambulatory cleft lip repair compared to inpatient cleft lip repair.
- To assess key parameters including time to first feeding and complication rates.
Main Methods:
- Retrospective analysis of 24 unilateral cleft lip repairs performed between 1989 and 1998.
- Two groups: Group 1 (N=11) ambulatory repair, Group 2 (N=13) inpatient repair.
- Evaluated surgical technique, ancillary procedures, local anesthetic, steroid use, feeding times, and complications.
Main Results:
- Ambulatory patients received a mixed local anesthetic and IV steroids more frequently (92% vs. 33%).
- Ambulatory group had significantly faster first postoperative feeding times (over 1 hour sooner, p < 0.05).
- No complications in the ambulatory group; two minor wound separations in the inpatient group.
Conclusions:
- Ambulatory cleft lip repair demonstrates safety and efficacy, comparable to inpatient procedures.
- Supports the continued practice of ambulatory cleft lip repair for improved patient outcomes and earlier home discharge.
- Facilitates earlier feeding and reduces complication rates, enhancing the infant's recovery process.