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Current surgical practices in cleft care: cleft palate repair techniques and postoperative care.

Abstract The purpose of this study was to objectively report practices commonly used in cleft palate repair in the United States. This study investigates current surgical techniques, postoperative care, and complication rates for cleft palate repair surgery.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title plastic and reconstructive surgery
Publication Year Start




PMID- 19730310
OWN - NLM
STAT- MEDLINE
DCOM- 20090923
LR  - 20150624
IS  - 1529-4242 (Electronic)
IS  - 0032-1052 (Linking)
VI  - 124
IP  - 3
DP  - 2009 Sep
TI  - Current surgical practices in cleft care: cleft palate repair techniques and
      postoperative care.
PG  - 899-906
LID - 10.1097/PRS.0b013e3181b03824 [doi]
AB  - BACKGROUND: The purpose of this study was to objectively report practices
      commonly used in cleft palate repair in the United States. This study
      investigates current surgical techniques, postoperative care, and complication
      rates for cleft palate repair surgery. METHODS: All 803 surgeon members of the
      American Cleft Palate-Craniofacial Association were sent online and/or paper
      surveys inquiring about their management of cleft palate patients. RESULTS:
      Three-hundred six surveys were received, a 38 percent response rate. This
      represented responses of surgeons from 100 percent of American Cleft
      Palate-Craniofacial Association registered cleft teams. Ninety-six percent of
      respondents perform a one-stage repair. Eighty-five percent of surgeons perform
      palate surgery when the patient is between 6 and 12 months of age. The most
      common one-stage repair techniques are the Bardach style (two flaps) with
      intravelar veloplasty and the Furlow palatoplasty. After surgery, 39 percent of
      surgeons discharge patients within 24 hours. Another 43 percent discharge
      patients within 48 hours. During postoperative management, 92 percent of
      respondents implement feeding restrictions. Eighty-five percent of physicians use
      arm restraints. Surgeons' self-reported complications rates are minimal: 54
      percent report a fistula in less than 5 percent of cases. The reported need for
      secondary speech surgery varies widely. CONCLUSIONS: The majority of respondents 
      repair clefts in one stage. The most frequently used repair techniques are the
      Furlow palatoplasty and the Bardach style with intravelar veloplasty. After
      surgery, the majority of surgeons discharge patients in 1 or 2 days, and nearly
      all surgeons implement feeding restrictions and the use of arm restraints. The
      varying feeding protocols are reviewed in this article.
FAU - Katzel, Evan B
AU  - Katzel EB
AD  - University of Rochester School of Medicine, Rochester, NY 14642, USA.
      [email protected]
FAU - Basile, Patrick
AU  - Basile P
FAU - Koltz, Peter F
AU  - Koltz PF
FAU - Marcus, Jeffrey R
AU  - Marcus JR
FAU - Girotto, John A
AU  - Girotto JA
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Plast Reconstr Surg
JT  - Plastic and reconstructive surgery
JID - 1306050
SB  - AIM
SB  - IM
CIN - Plast Reconstr Surg. 2012 Apr;129(4):745e-6e. PMID: 22456403
MH  - Cleft Palate/*surgery
MH  - Data Collection
MH  - Humans
MH  - Infant
MH  - Postoperative Care/*methods/statistics & numerical data
MH  - Postoperative Complications/epidemiology
MH  - Reconstructive Surgical Procedures/adverse effects/*methods/statistics &
      numerical data
MH  - United States
EDAT- 2009/09/05 06:00
MHDA- 2009/09/24 06:00
CRDT- 2009/09/05 06:00
PHST- 2009/09/05 06:00 [entrez]
PHST- 2009/09/05 06:00 [pubmed]
PHST- 2009/09/24 06:00 [medline]
AID - 10.1097/PRS.0b013e3181b03824 [doi]
AID - 00006534-200909000-00025 [pii]
PST - ppublish
SO  - Plast Reconstr Surg. 2009 Sep;124(3):899-906. doi: 10.1097/PRS.0b013e3181b03824.