Our Summary

This research paper is about a new approach to performing cleft lip repair surgeries. Traditionally, these surgeries have required the patient to stay in the hospital, but there’s been interest in moving towards doing these surgeries on an outpatient basis. The main goal of this shift is to lower healthcare costs and avoid unnecessary hospital stays.

The researchers studied patients who had these surgeries between 2012 and 2021 and found that, when a new outpatient surgery protocol was introduced in 2016, there was no difference in the rate of patients having to be readmitted, needing reoperation, or having post-surgery complications, when compared with patients treated before the protocol was introduced.

They also found that, after introducing the outpatient surgery protocol, 80% of patients with a unilateral cleft lip (cleft lip on one side) and 56% of patients with a bilateral cleft lip (cleft lip on both sides) could have their surgeries done on an outpatient basis. The average length of stay at the hospital fell from 24 hours to 8 hours.

For the patients who did need to stay overnight in the hospital, it was usually because they had other health conditions that required monitoring. Even in these cases, there were no differences in surgical outcomes compared with the outpatient group.

In simple terms, the study suggests that cleft lip repair surgeries can be safely done on an outpatient basis, reducing the length of hospital stays without negatively affecting the results of the surgery.

FAQs

  1. What is the main goal of shifting cleft lip repair surgeries from inpatient to outpatient procedures?
  2. Did the introduction of the new outpatient surgery protocol for cleft lip repair increase the rate of post-surgery complications or need for reoperation?
  3. What percentage of patients with unilateral and bilateral cleft lip were able to have their surgeries done on an outpatient basis after the introduction of the outpatient protocol?

Doctor’s Tip

A helpful tip that a doctor might give a patient undergoing cleft lip repair surgery is to follow all pre-operative instructions provided by the surgical team. This may include fasting before the surgery, avoiding certain medications, and preparing for post-operative care. By following these instructions, the patient can help ensure a successful surgery and smooth recovery process.

Suitable For

Patients who are generally recommended for cleft lip repair surgery include infants and children born with a cleft lip or palate. These patients may have difficulty with feeding, speech development, and overall facial appearance. The decision to undergo surgery is typically made by a multidisciplinary team of healthcare professionals, including plastic surgeons, oral surgeons, pediatricians, and speech therapists. The timing of the surgery may vary depending on the severity of the cleft and the overall health of the patient. In some cases, multiple surgeries may be required to fully repair the cleft lip and palate.

Timeline

Before cleft lip repair:

  • Patient is diagnosed with a cleft lip
  • Patient and family receive counseling and education about the surgical procedure
  • Preoperative appointments and tests are scheduled
  • Patient undergoes cleft lip repair surgery in the hospital
  • Patient stays in the hospital for an average of 24 hours post-surgery for monitoring and recovery

After cleft lip repair:

  • New outpatient surgery protocol introduced in 2016
  • 80% of patients with unilateral cleft lip and 56% of patients with bilateral cleft lip can have surgery on an outpatient basis
  • Average length of hospital stay reduced to 8 hours
  • Patients who stay overnight usually have other health conditions requiring monitoring
  • No significant differences in surgical outcomes between outpatient and inpatient groups

Overall, the new approach to performing cleft lip repair surgeries on an outpatient basis has shown to be safe and effective in reducing hospital stays and healthcare costs, without compromising surgical outcomes.

What to Ask Your Doctor

Some questions a patient should ask their doctor about cleft lip repair include:

  1. What are the potential risks and complications associated with cleft lip repair surgery?
  2. How experienced is the surgical team in performing cleft lip repair surgeries?
  3. Will I need to stay in the hospital overnight after the surgery, or can it be done on an outpatient basis?
  4. What is the expected recovery time after cleft lip repair surgery?
  5. How should I prepare for the surgery, both physically and mentally?
  6. Are there any special post-operative care instructions I should follow?
  7. Will I need any follow-up appointments after the surgery?
  8. How can I manage any pain or discomfort after the surgery?
  9. Are there any long-term effects or considerations I should be aware of after cleft lip repair surgery?
  10. What are the expected results and outcomes of the surgery in terms of appearance and function?

Reference

Authors: Park JJ, Colon RR, Chaya BF, Rochlin DH, Chibarro PD, Shetye PR, Staffenberg DA, Flores RL. Journal: Cleft Palate Craniofac J. 2023 Oct;60(10):1220-1229. doi: 10.1177/10556656221096567. Epub 2022 Apr 25. PMID: 35469454