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Should surgeons use arm restraints after cleft surgery?
Brett Michelotti1, Ross E Long, David Leber
1Pennsylvania State University, Milton S. Hershey Medical Center, Hershey, PA 17033, USA. bmichelotti@hmc.psu.edu
Insights
Postoperative arm restraints are not effective in preventing early complications after cleft surgery. Eliminating their use in cleft care can save healthcare costs and reduce patient distress.
Area of Science:
- Cleft lip and palate surgery
- Pediatric surgical outcomes
- Postoperative care protocols
Background:
- Cleft surgeons commonly use arm restraints post-surgery.
- Existing literature shows no difference in early complications with or without restraints.
Purpose of the Study:
- To evaluate the effectiveness of arm restraints in preventing early postoperative complications in cleft surgery.
Main Methods:
- Retrospective review of 120 primary cleft surgeries.
- Comparison of complication rates (infection, fistula, dehiscence) between patients with and without arm restraints.
- Data collected from two surgeons with differing restraint protocols.
Main Results:
- No statistically significant difference in early complications was observed between the two groups (P<0.05).
- Arm restraints did not prevent infection, fistula, or dehiscence.
Conclusions:
- Arm restraints are unnecessary in cleft care.
- Eliminating arm restraints can reduce patient and family distress.
- Potential annual healthcare savings of $234,000 by discontinuing restraint use.
Background:
Most cleft surgeons require children to wear postoperative arm restraints although the literature suggests that there is no difference in early complications. The aim of this study was to determine if the use of postoperative arm restraints was effective in preventing early postoperative complications.
Methods:
We reviewed 120 consecutive primary cleft surgeries in which 1 surgeon used arm restraints in all patients and the other surgeon did not. Demographic information was obtained and complications were reviewed. We compared infection, fistula, and dehiscence between the 2 groups.
Results:
In 120 primary cleft surgeries, there was no difference in early complications in patients who were required to wear arm restraints versus those who were not (P<0.05).
Discussion:
Arm restraints are unnecessary and may cause distress in both patients and their families. Eliminating arm restraints from cleft care would save the health care system an estimated $234,000 annually.