Risk Factors for Infection, Dehiscence, and Unplanned Reintubation Following Cleft Lip Repair

Area of Science:

• Pediatric Surgery
• Plastic Surgery
• Surgical Outcomes Research

Background:

• Cleft lip repair (CLR) is a common pediatric surgical procedure.
• Understanding postoperative complication factors is crucial for improving patient outcomes.
• The National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database offers valuable data for such analyses.

Purpose of the Study:

• To identify factors associated with postoperative complications following primary cleft lip repair (CLR).
• To analyze the incidence of surgical site infection (SSI), wound dehiscence, and unplanned reintubation within 30 days of CLR.
• To determine the impact of cleft anatomy and anesthesia duration on these complications.

Main Methods:

• Utilized the NSQIP-P database to identify 11,957 patients under 12 months old undergoing CLR.
• Performed multivariable analysis to assess complications and associated comorbidities.
• Focused on outcomes including surgical site infection (SSI), wound dehiscence, and unplanned reintubation.

Main Results:

• Surgical site infections (SSI) occurred in 0.6% of cases, associated with bilateral cleft lip and longer anesthesia time.
• Wound dehiscence occurred in 0.4% of patients, linked to bilateral cleft lip and shorter anesthesia duration.
• Unplanned reintubation (0.2% of cases) was associated with higher rates of multiple comorbidities.

Conclusions:

• Postoperative complications like SSI, wound dehiscence, and unplanned reintubation are rare following CLR.
• Patients with bilateral cleft lip anatomy have a significantly increased risk of both SSI and wound dehiscence.
• Anesthesia time and patient comorbidities are important factors influencing complication rates in CLR.