Abstract
Early postoperative home care after pediatric surgery, including primary cleft lip repairs, allows both the patients and the parents to be in a more comfortable and familiar environment. Therefore, we have been performing primary cleft lip repairs using a clinical pathway with a 3-day hospital stay since September 2006.
The features of our clinical pathway are as follows:
1: Avoiding suture removal by using absorbable sutures for closure of the vermilion mucosa and deep dermal layer, and applying Dermabond® for skin adhesion.
2: Usual sucking is allowed after 3 hours.
3: Intravenous hydration is finished on the day of the operation, if possible.
4: Intravenous antibiotics are administrated only during the operation.
5: No arm restrictions are used.
We retrospectively reviewed 96 patients who underwent primary cleft lip repairs from 1998 to 2008. The patients were divided into two groups: patients with no clinical pathway from 1998 to 2006(group 1), and those managed with the clinical pathway from 2006 to 2008(group 2). Parameters considered for each group were length of hospital stay and complications within 2 weeks of operation.
The average length of hospital stay was 6.8 days in group 1 and 3.0 days in group 2. There was no significant difference between the groups in complication rate(p < 0.05).
Our data support the safety of primary cleft lip repair performed with a 3-day hospital stay and the efficacy of our clinical pathway.
