Early Surgical Complications After Primary Cleft Lip Repair: A Report of 3108 Consecutive Cases
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Updated: Apr 23, 2026
Surgical Correction for Pediatric Epiblepharon and Trichiasis
Published on: July 8, 2025
Insights
Short-term surgical complications after primary cleft lip repair are analyzed. Wound dehiscence is common in bilateral complete clefts, but experienced surgeons can reduce this risk.
Area of Science:
- Plastic Surgery
- Pediatric Surgery
- Craniofacial Surgery
Background:
- Primary cleft lip repair is a common surgical procedure.
- Understanding short-term complications is crucial for optimizing patient outcomes.
- Factors influencing complication rates require further investigation.
Purpose of the Study:
- To analyze the incidence and types of short-term surgical complications following primary cleft lip repair.
- To identify risk factors associated with specific complications such as wound dehiscence and infection.
Main Methods:
- Retrospective review of 3108 primary cleft lip repairs with 2062 follow-ups.
- Data collection on complications including dehiscence, necrosis, infection, and suture granuloma.
- Logistic regression analysis to determine associations between patient/surgical factors and complications.
Main Results:
- Overall complication rate was 4.4% (90/2062), with wound dehiscence (3.2%) and infection (1.1%) being most frequent.
- Bilateral complete clefts and complete clefts were significantly associated with wound dehiscence and infection, respectively.
- Patients with bilateral complete clefts had a 6.9% rate of wound dehiscence.
Conclusions:
- Wound dehiscence is a notable complication in bilateral complete cleft repairs, particularly in settings without presurgical molding.
- Assigning experienced surgeons to complex cases, such as bilateral complete clefts, can mitigate the risk of dehiscence.
- Low rates of wound infection are achievable without routine postoperative antibiotics.
Objective:
To analyze short term surgical complications after primary cleft lip repair.
Patients And Design:
A total of 3108 consecutive lip repairs with 2062 follow-ups were reviewed retrospectively through medical records. Patients were aged 3 months to 75 years at the time of surgery, with a median of 7 years.
Setting:
Guwahati Comprehensive Cleft Care Center, Assam, India.
Intervention:
Primary cleft lip repair.
Main Outcome Measures:
Documented complications in terms of dehiscence, necrosis, infection, and suture granuloma were compiled. Logistic regression was used with dehiscence (yes/no) or infection (yes/no) as binary dependant variables. Age, cleft type, and surgeon (visiting/long term) were used as covariates.
Results:
Among the 2062 patients who returned for early follow-up, 90 (4.4%) had one or more complications. Dehiscence (3.2%) and infection (1.1%) were the most common types of complication. Visiting surgeon, complete cleft, and bilateral cleft were significantly associated with wound dehiscence, and complete cleft was associated with wound infection according to the logistic regression analysis. Of patients with bilateral complete clefts, 6.9% suffered from some degree of wound dehiscence.
Conclusion:
In a setting where presurgical molding is unavailable and patients present at all ages, lip wound dehiscence is a relatively common complication in patients with bilateral complete clefts. The risk of dehiscence, however, is reduced when these cases are assigned to surgeons with experience with these types of clefts. We also found that the incidence of wound infection can be kept relatively low, even without the use of postoperative antibiotics.
