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Related Experiment Videos

Ambulatory alveolar bone grafting.

Charles W Perry1, Adam Lowenstein, Douglas M Rothkopf

  • 1Department of Surgery, University of Massachusetts, Boston, Massachusetts, USA. perry@comcast.net

Plastic and Reconstructive Surgery
|September 6, 2005
PubMed
Summary

Outpatient alveolar cleft bone grafting using the iliac crest donor site is safe and effective. This approach allows patients to recover at home, improving the overall surgical experience.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Pediatric Plastic Surgery
  • Anesthesiology

Background:

  • Traditional alveolar cleft closure necessitates inpatient recovery, often in a disruptive hospital environment.
  • An optimized protocol for ambulatory iliac crest alveolar bone grafting was developed to enhance patient care.

Purpose of the Study:

  • To evaluate the safety and efficacy of an outpatient protocol for alveolar cleft closure.
  • To compare outcomes of ambulatory versus inpatient alveolar bone grafting procedures.

Main Methods:

  • A retrospective review compared 5 years of outpatient (1998-2004) versus inpatient (1993-1998) alveolar cleft closure.
  • Both groups utilized iliac crest bone grafts; the outpatient group received enhanced preemptive analgesia and antiemetic protocols.

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  • Complications, including morbidity, readmission, and reoperations, were statistically analyzed.

    • Main Results:

    • Twenty patients underwent outpatient procedures, with an average age of 12.1 years.
    • The outpatient group experienced a 10% complication rate (minor cellulitis, suture dehiscence), with no readmissions or graft losses.
    • The inpatient group had a 12.5% complication rate, a difference not statistically significant compared to the outpatient group.

    Conclusions:

    • Alveolar cleft bone grafting can be safely performed in an outpatient setting with adequate pain control and caregiver support.
    • Outpatient surgery allows patients to recover in a familiar home environment, benefiting both patients and families.