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Comparative Study
. 2018 May;141(5):697e-706e.
doi: 10.1097/PRS.0000000000004293.

Outpatient versus Inpatient Primary Cleft Lip and Palate Surgery: Analysis of Early Complications

Rami S Kantar  1   2 , Michael J Cammarata  1   2 , William J Rifkin  1   2 , Natalie M Plana  1   2 , J Rodrigo Diaz-Siso  1   2 , Roberto L Flores  1   2
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Comparative Study

Outpatient versus Inpatient Primary Cleft Lip and Palate Surgery: Analysis of Early Complications

Rami S Kantar et al. Plast Reconstr Surg. 2018 May.

Abstract

Background: Fiscal constraints are driving shorter hospital lengths of stay. Outpatient primary cleft lip surgery has been shown to be safe, but outpatient primary cleft palate surgery remains controversial. This study evaluates outcomes following outpatient versus inpatient primary cleft lip and palate surgery.

Methods: The American College of Surgeons National Surgical Quality Improvement Program Pediatric database was used to identify patients undergoing primary cleft lip and palate surgery between 2012 and 2015. Patient clinical factors and 30-day complications were compared for outpatient versus inpatient primary cleft lip and palate surgery. Univariate and multivariate analyses were performed.

Results: Three thousand one hundred forty-two patients were included in the primary cleft lip surgery group and 4191 in the primary cleft palate surgery group. Patients in the cleft lip surgery group with structural pulmonary abnormalities had a significantly longer hospital length of stay (β, 4.94; p = 0.001). Patients undergoing outpatient surgery had a significantly higher risk of superficial (OR, 1.99; p = 0.01) and deep wound dehiscence (OR, 2.22; p = 0.01), and were at a significantly lower risk of reoperation (OR, 0.36; p = 0.04) and readmission (OR, 0.52; p = 0.02).

Conclusions: Outpatient primary cleft lip surgery is safe and has a complication profile similar to that of inpatient surgery. Outpatient primary cleft palate surgery is common practice in many U.S. hospitals and has a significantly higher rate of wound complications, and lower rates of reoperation and readmission. In properly selected patients, outpatient palatoplasty can be performed safely.

Clinical question/level of evidence: Therapeutic, III.

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References

    1. Parker SE, Mai CT, Canfield MA, et alNational Birth Defects Prevention Network. Updated National Birth Prevalence estimates for selected birth defects in the United States, 2004-2006. Birth Defects Res A Clin Mol Teratol. 2010;88:10081016.
    1. Cassell CH, Meyer R, Daniels JHealth care expenditures among Medicaid enrolled children with and without orofacial clefts in North Carolina, 1995-2002. Birth Defects Res A Clin Mol Teratol. 2008;82:785794.
    1. Lees VC, Pigott RWEarly postoperative complications in primary cleft lip and palate surgery: How soon may we discharge patients from hospital? Br J Plast Surg. 1992;45:232234.
    1. Hopper RA, Lewis C, Umbdenstock R, Garrison MM, Starr JRDischarge practices, readmission, and serious medical complications following primary cleft lip repair in 23 U.S. children’s hospitals. Plast Reconstr Surg. 2009;123:15531559.
    1. Rosen H, Barrios LM, Reinisch JF, Macgill K, Meara JGOutpatient cleft lip repair. Plast Reconstr Surg. 2003;112:381387; discussion 388389.

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