Thresholds for Safety of Cleft Lip Surgery in Premature Infants

Area of Science:

• Pediatric Surgery
• Neonatal Care
• Craniofacial Anomalies

Background:

• Cleft lip repair is a common surgical procedure in infants.
• Premature infants present unique challenges and risks for surgical interventions.
• Optimal timing for cleft lip repair in premature infants remains debated.

Purpose of the Study:

• To determine the ideal age for performing unilateral or bilateral cleft lip repair in premature patients.
• To analyze the association between prematurity and adverse surgical outcomes.
• To identify age thresholds for improved safety in cleft lip repair for premature infants.

Main Methods:

• Utilized the American College of Surgeons National Surgical Quality Improvement Program Pediatric database (2012-2017).
• Analyzed data for unilateral and bilateral cleft lip repairs in premature patients.
• Statistical analysis of complications, readmissions, and reoperations in relation to prematurity and repair timing.

Main Results:

• Degree of prematurity significantly correlated with adverse events (p = 0.001).
• Unilateral cleft lip repair after 150 days of age showed a significantly decreased risk of adverse events (OR, 18.1; p = 0.004).
• Bilateral cleft lip repair after 175 days of age demonstrated a significantly decreased risk of adverse events (OR, 16.1; p = 0.010).

Conclusions:

• Performing unilateral cleft lip repair after 150 days of age is associated with reduced adverse events in premature infants.
• Performing bilateral cleft lip repair after 175 days of age is associated with reduced adverse events in premature infants.
• These findings suggest age-based surgical timing guidelines can improve outcomes for premature infants undergoing cleft lip repair.