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

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This study analyzed over 11,000 cleft lip repairs (CLR). Bilateral cleft lip anatomy and longer anesthesia time increased surgical site infections, while bilateral cleft lip also raised wound dehiscence risk.

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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.