Multidisciplinary Collaborative Efforts in Craniosynostosis Surgery-A Rural Appalachian Institutional Experience in...

Craniosynostosis surgery, addressing the premature fusion of cranial sutures, presents a unique challenge requiring standardized care, especially in rural settings, to optimize patient outcomes. This study evaluates surgical outcomes from 2012 to 2021, with a focus on 2020-2021, assessing intraoperative red cell-containing products, blood donor exposures, antifibrinolytic use, and ICU and hospital stays across various hospitals, with emphasis on our Rural Appalachian Institution (RAI). Primary outcomes include perioperative blood transfusion rates and hospital stay duration. Secondary outcomes include antifibrinolytic usage and blood donor exposures. Statistical analyses were performed using ANOVA and chi-square tests where applicable, with a significance threshold of p < 0.05. Results indicate that preoperative erythropoietin administration at RAI contributed to reduced perioperative blood transfusions. Increased antifibrinolytic use at RAI underscores efforts to minimize transfusions. Despite variations in ICU and hospital stays, RAI's standardized protocols address regional challenges and highlight the necessity for best practices in craniosynostosis care. Future research should explore the impact of erythropoietin on blood conservation, postoperative dexmedetomidine infusion on recovery, and tranexamic acid on perioperative blood management. This study, while acknowledging limitations, provides essential insights for refining surgical protocols in resource-limited settings.