Our Summary

This study aimed to understand the knowledge and use of ERAS (Enhanced Recovery After Surgery) protocols among craniofacial surgeons, specifically those performing cleft palate surgeries. These protocols are designed to speed up recovery and reduce complications after surgery.

The researchers conducted an online survey of 102 cleft palate surgeons, with 31 completing the survey. They found that while most surgeons (67.7%) were aware of ERAS, over half (61.3%) did not use a standard protocol for their surgeries.

However, several elements of ERAS are already being used by a majority of surgeons. These include avoiding long periods of fasting before surgery (67.7%), measures to prevent hypothermia (74.2%), and minimizing use of opioids (62.5%).

Regarding the use of tranexamic acid, a medication that helps reduce bleeding, most surgeons said they did not administer it and did not believe it would be a valuable addition to their protocol.

The use of short-acting sedatives varied, with some surgeons using them in all patients during recovery, and others never using them.

In conclusion, while not all surgeons use a standardized ERAS protocol, many are using elements of it and most are open to implementing it in the future.

FAQs

  1. What is the purpose of ERAS protocols in relation to cleft palate surgeries?
  2. What percentage of surgeons surveyed use a standard ERAS protocol for their surgeries?
  3. What elements of ERAS protocols are most commonly used by cleft palate surgeons?

Doctor’s Tip

One helpful tip a doctor might tell a patient about cleft palate surgery is to follow the recommended pre-operative and post-operative care instructions closely. This may include avoiding certain medications, adhering to a specific diet, and practicing good oral hygiene to reduce the risk of infection and promote healing. It is also important for patients to attend all follow-up appointments and communicate any concerns or changes in symptoms to their healthcare provider. By following these guidelines, patients can help ensure a successful recovery and optimal outcome from their cleft palate surgery.

Suitable For

Patients who are typically recommended cleft palate surgery are those who have a congenital cleft palate or cleft lip, which can affect their ability to eat, speak, and breathe properly. Surgery is often recommended early in life to improve these functions and also to improve the patient’s appearance and overall quality of life. Each patient’s case is unique, so the decision to undergo cleft palate surgery is made on a case-by-case basis by a team of healthcare professionals, including craniofacial surgeons.

Timeline

Before cleft palate surgery, a patient typically undergoes a series of consultations with their surgeon and medical team to discuss the procedure, risks, and expected outcomes. They may also undergo pre-operative testing and evaluations to ensure they are healthy enough for surgery.

On the day of surgery, the patient will be admitted to the hospital and prepared for the procedure. The surgery itself usually takes a few hours and involves repairing the cleft in the palate using specialized techniques.

After surgery, the patient will be monitored closely in the recovery room before being transferred to a regular hospital room. They will likely experience some pain and discomfort, which will be managed with medication. Swelling, bruising, and difficulty eating and speaking may also occur in the days following surgery.

Over the next few weeks, the patient will have several follow-up appointments with their surgeon to monitor healing and progress. Speech therapy and other treatments may also be recommended to help with recovery and improve speech and feeding abilities.

Overall, cleft palate surgery can significantly improve the patient’s quality of life and overall health, but it is important to follow the post-operative care instructions provided by the medical team to ensure a successful recovery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about cleft palate surgery in relation to ERAS protocols include:

  1. Are you familiar with ERAS protocols for cleft palate surgery?
  2. Do you have a standardized protocol in place for cleft palate surgeries?
  3. Do you implement measures to prevent long periods of fasting before surgery?
  4. How do you prevent hypothermia during surgery?
  5. What is your approach to minimizing the use of opioids after surgery?
  6. Do you administer tranexamic acid to help reduce bleeding during surgery?
  7. Do you use short-acting sedatives during recovery?
  8. How do you tailor your surgical approach to promote a faster recovery for patients?

Reference

Authors: Grabar C, Fligor J, Kanack M, Walsh J, Kim J, Vyas R. Journal: Cleft Palate Craniofac J. 2023 Oct;60(10):1305-1312. doi: 10.1177/10556656221103756. Epub 2022 May 26. PMID: 35619553