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Ambulatory Cleft Lip Repair

Al-Thunyan, Abdulla M., M.D.; Aldekhayel, Salah A., M.B.B.S.; Al-Meshal, Obaid, M.D.; Al-Qattan, Mohammad M., F.R.C.S.C.

Plastic and Reconstructive Surgery: December 2009 - Volume 124 - Issue 6 - p 2048-2053
doi: 10.1097/PRS.0b013e3181bcf305
PEDIATRIC/CRANIOFACIAL: ORIGINAL ARTICLES
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Background: Ambulatory cleft lip repair has been practiced in developed countries, but its safety has never been examined in developing countries. This study compares the outcomes of ambulatory cleft lip repair with the inpatient setting.

Methods: A retrospective cohort study of 122 patients who underwent repair between 2000 and 2008 was conducted. All patients underwent primary cleft lip repair performed by the same surgeon. Patients were divided into two groups: ambulatory (n = 58) and inpatient (n = 64). Demographics, surgical parameters, and outcomes were obtained. The main outcome measure examined was the overall readmission rate.

Results: Mean patient age was 133 days in the ambulatory group and 154 days in the inpatient group. Six patients (10.3 percent) in the ambulatory group and 15 (23.4 percent) in the inpatient group had associated medical problems. Both groups were homogeneous for other parameters. Three patients (5.2 percent) in the ambulatory group and two (3.1 percent) in the inpatient group were readmitted. There were no significant differences in the readmission rate, intraoperative or postoperative complications, or rate of return to the emergency room (p > 0.05). However, the reason for readmission was different in the two groups, consisting of respiratory problems in the ambulatory group and late wound dehiscence in the inpatient group.

Conclusions: This study confirms the safety of ambulatory cleft lip repair in a developing country. However, the authors suggest hospital admission for patients with preexisting cardiac problems and those who experience any respiratory problems in the immediate postoperative period in the ambulatory group.

Riyadh, Saudi Arabia

From the Plastic Surgery Division, Department of Surgery, King Abdulaziz Medical City; King Saud bin Abdulaziz University for Health Sciences; and King Saud University.

Received for publication April 20, 2009; accepted July 1, 2009.

Presented at the Second International Cleft Lip and Palate Workshop, King Faisal Specialist Hospital and Research Center, in Riyadh, Saudi Arabia, March 31 through April 2, 2009, and at the Eleventh Congress of the European Society of Plastic, Reconstructive, and Aesthetic Surgery, in Rhodes, Greece, September 26, 2009.

Disclosure:The authors have no financial or personal relationships with other people or organizations that could bias this work.

Abdulla M. Al-Thunyan, M.D., Plastic Surgery Division, Department of Surgery, MC 1446, King Abdulaziz Medical City, P.O. Box 22490, Riyadh 11426, Saudi Arabia, althunyan@hotmail.com

©2009American Society of Plastic Surgeons