Surgical Team Trips to Vietnam: Implementation of a Dedicated Cleft Palate Perioperative Program Improves Fistula...

Area of Science:

• Global Health
• Surgical Innovation
• Craniofacial Surgery

Background:

• ReSurge International conducts surgical trips to low- and middle-income countries, frequently performing cleft palate repair.
• A comprehensive cleft care program was implemented to decrease postoperative palatal fistula rates.

Purpose of the Study:

• To evaluate the impact of a comprehensive cleft care program on postoperative palatal fistula rates.
• To assess parent-reported outcomes in patients undergoing cleft palate repair.

Main Methods:

• Retrospective review of 203 patients undergoing cleft palate repair in Vietnam (2013-2019).
• Intervention (implemented 2018) included preoperative education, close postoperative monitoring, and physician follow-up.
• Parent-reported outcomes assessed pre- and postoperatively using Likert-like surveys.

Main Results:

• Palatal fistula rate decreased from 37.5% pre-intervention to 14.3% post-intervention (P = 0.014).
• Patients without fistulas showed improved outcomes: less nasal regurgitation (P < 0.001), easier eating (P < 0.001), and clearer speech (P = 0.015).

Conclusions:

• A comprehensive cleft care program significantly reduced postoperative fistula rates by over 50%.
• Improved parent-reported outcomes were noted in patients without fistulas.
• Key elements for success include enhanced perioperative counseling, close follow-up, and sustained patient communication.