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Postoperative Bleeding After Facial Cleft Repair: A Retrospective Review of TriNetX Database
Emily L Isch1, Sydney Somers2, Aviana Duca1
1Department of Surgery, Thomas Jefferson University Hospital.
The Journal of Craniofacial Surgery
|March 27, 2025
Summary
Postoperative hemorrhage after cleft palate repair (palatoplasty) requiring transfusion or return to the operating room is less common than previously reported. This study found a lower incidence of bleeding complications in over 13,000 patients.
Area of Science:
- Craniofacial Surgery
- Pediatric Surgery
- Surgical Outcomes Research
Background:
- Postoperative hemorrhage is a known complication following cleft palate repair (palatoplasty).
- Previous literature suggests a moderate incidence of bleeding requiring intervention.
- Accurate incidence data is crucial for patient counseling and surgical planning.
Purpose of the Study:
- To assess the incidence of postoperative hemorrhage after primary palatoplasty.
- To determine the rate of blood transfusion and return to the operating room for hemorrhage management.
- To compare current incidence rates with historical data.
Main Methods:
- Retrospective analysis of the TriNetX federated database (2003-2023).
- Inclusion of patients undergoing primary cleft palate repair.
- Assessment of endpoints: postoperative hemorrhage, blood transfusion, and return to the operating room.
Main Results:
- 13,161 patients underwent palatoplasty over 20 years.
- 97 patients were diagnosed with postoperative bleeding.
- 175 patients required blood transfusion; 70 required return to the operating room for bleeding.
Conclusions:
- The incidence of postoperative hemorrhage after palatoplasty is lower than historically reported.
- While transfusion and reoperation for bleeding can occur, they are not frequent.
- This national database review provides updated, lower incidence figures for palatoplasty bleeding complications.
