Should We Give Routine Postoperative Intravenous Fluids After Cleft Surgery?

Area of Science:

• Pediatric Surgery
• Craniofacial Surgery
• Postoperative Care

Background:

• The James Lind Alliance identified cleft management priorities, including postoperative fluid management.
• Current practice varies regarding the necessity of intravenous fluids post-cleft surgery.

Purpose of the Study:

• To audit the safety and appropriateness of a postoperative fluid management regimen that omits routine intravenous fluids for cleft surgery patients.
• To evaluate the impact of this regimen on patient outcomes, including length of stay and complication rates.

Main Methods:

• An audit of 79 patients undergoing cleft-related surgery between August 2011 and August 2012.
• Data collected included patient demographics, surgery type, fluid requirements, length of stay, and readmissions/returns to theater.

Main Results:

• No patients required readmission or return to theater.
• The mean length of stay was 1.72 days.
• Intravenous fluids were required by 24% of patients, predominantly older children, while only 1 of 20 youngest patients needed them.

Conclusions:

• Omitting routine postoperative intravenous fluids is safe and effective, particularly for younger cleft surgery patients.
• This approach is associated with a shorter length of stay.
• Early postoperative feeding and promoting physiological fluid balance are recommended.