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Do babies require arm splints after cleft palate repair?
V Jigjinni1, T Kangesu, B C Sommerlad
1North East Thames Regional Plastic Surgery Unit, St Andrew's Hospital, Billericay, Essex, UK.
British Journal of Plastic Surgery
|December 1, 1993
Summary
Arm splints are commonly used after cleft palate repair but a study found they do not prevent oronasal fistulae. This research suggests abandoning their routine use in postoperative care for children.
Area of Science:
- Pediatric Plastic Surgery
- Craniofacial Surgery
- Surgical Outcomes Research
Background:
- Arm restraints are traditionally used post-cleft palate surgery to prevent disruption of the surgical repair.
- A UK survey indicated widespread use of arm splints among consultant plastic surgeons.
- The efficacy of arm splints in preventing complications after cleft palate repair has been questioned.
Purpose of the Study:
- To evaluate the effectiveness of postoperative arm splints in reducing the incidence of oronasal fistulae following primary cleft palate repair.
- To provide evidence-based guidance on the use of arm restraints in pediatric cleft surgery.
Main Methods:
- A prospective randomized trial involving 46 children undergoing primary cleft palate repair.
- Children were randomly assigned to receive either postoperative arm splints or no splints.
- The incidence of oronasal fistulae was compared between the two groups.
Main Results:
- Arm splints did not significantly decrease the incidence of oronasal fistulae.
- Oronasal fistulae developed in 6 of 21 children (28.6%) who used arm splints.
- Oronasal fistulae developed in 5 of 25 children (20%) who did not use arm splints.
Conclusions:
- Postoperative arm splints are not effective in preventing oronasal fistulae after primary cleft palate repair.
- The routine use of arm splints following cleft palate repair should be abandoned.
- Clinical practice should be updated based on this evidence to improve patient outcomes.