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Perioperative corticosteroid reduces hospital stay after fronto-orbital advancement
James E Clune1, Arin K Greene, Chao-Yu Guo
1Department of Plastic Surgery, Children's Hospital Boston, Harvard Medical School, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts 02115, USA.
Insights
Perioperative corticosteroid administration significantly reduced hospital stays for children undergoing fronto-orbital advancement. This treatment shortened recovery time without increasing infection rates, offering a more cost-effective approach.
Area of Science:
- Pediatric Surgery
- Craniofacial Surgery
- Pharmacology in Surgery
Background:
- Facial swelling and eyelid closure are common complications following fronto-orbital advancement surgery.
- These complications can lead to extended hospital stays for pediatric patients.
Purpose of the Study:
- To evaluate the efficacy of perioperative corticosteroid use in reducing hospital stay duration after fronto-orbital advancement.
- To assess the impact of corticosteroids on postoperative infection rates in this patient population.
Main Methods:
- Retrospective study of 161 pediatric patients under 2 years old who underwent primary fronto-orbital advancement.
- Patients were divided into two groups: one receiving no corticosteroids and the other receiving tapered perioperative dexamethasone.
- Primary outcome measures included length of hospital stay and incidence of infection.
Main Results:
- The group receiving perioperative corticosteroids had a significantly shorter median hospital stay (3.0 days) compared to the control group (5.0 days) (P = 0.008).
- There was no statistically significant difference in postoperative infection rates between the corticosteroid group (1.5%) and the non-corticosteroid group (2.1%) (P = 0.8).
Conclusions:
- Perioperative corticosteroid administration is effective in shortening hospitalization after fronto-orbital advancement in pediatric patients.
- This approach reduces hospital stay duration without compromising patient safety by increasing infection risk.
- The use of corticosteroids resulted in a 27.2% reduction in postoperative hospital care costs.
Abstract:
Facial swelling is common after fronto-orbital advancement. Edema and closure of the palpebral fissures can lead to prolonged hospitalization. The purpose of this study was to determine if perioperative corticosteroid shortens hospital stay after this procedure.We retrospectively studied consecutive children younger than 2 years who underwent primary fronto-orbital advancement between 1990 and 2008. Patients were categorized into 2 groups: group 1 patients were not given corticosteroid; group 2 patients received tapered perioperative dexamethasone. Primary outcome variables included length of hospital stay and infection rate.A total of 161 patients were included in the study. Hospitalization was significantly shorter (P = 0.008) for group 2 (n = 65; median duration, 3.0 d) than group 1 (n = 96; median duration, 5.0 d). Infection rates did not differ between groups (group 1, 2.1%; group 2, 1.5%; P = 0.8).Perioperative corticosteroid shortens hospitalization after fronto-orbital advancement without increasing the incidence of postoperative infection. The cost of postoperative hospital care was reduced by 27.2%.
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