Surgical Team Trips to Vietnam: Implementation of a Dedicated Cleft Palate Perioperative Program Improves Fistula Rates.
Ann Plast Surg
; 87(5): 528-532, 2021 11 01.
Article
em En
| MEDLINE
| ID: mdl-33661215
ABSTRACT
BACKGROUND:
ReSurge International is a nongovernmental organization that organizes surgical team trips to low- and middle-income countries. Cleft palate repair is commonly performed on these trips. A comprehensive cleft care program was implemented to help reduce postoperative palatal fistula rates.METHODS:
A retrospective review of all patients undergoing cleft palate repair surgery with ReSurge International in Vietnam from 2013 through 2019 was performed. The cleft care program was implemented in 2018. This intervention involved preoperative education of patients and close postoperative monitoring. Critically, this program also provided closer access to providers. Subsequent follow-up was performed by a ReSurge physician. Parent-reported outcomes were assessed preoperatively and postoperatively using 5-point Likert-like survey questions.RESULTS:
Two hundred three patients underwent cleft palate repair. The patients were older and of higher Veau classification than is usually seen in the United States. The palatal fistula rate in the preintervention group was 37.5% and 14.3% in the intervention group (P = 0.014). Patients without fistulas demonstrated improvements on parent-reported outcomes compared with those with fistulas, with food less likely to go up their nose (P < 0.001), less difficulty eating (P < 0.001), and more understandable speech (P = 0.015).CONCLUSIONS:
Implementation of a comprehensive cleft palate program reduced postoperative fistula rates by more than 50%. Improvements in parent-reported outcomes were observed after surgery among patients without fistulas. The blueprint for improved outcomes in these more complex patients includes enhanced perioperative patient counseling, close follow-up, and maintenance of communication with patients.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Fissura Palatina
/
Procedimentos de Cirurgia Plástica
/
Fístula
Tipo de estudo:
Observational_studies
/
Sysrev_observational_studies
Limite:
Humans
/
Infant
País/Região como assunto:
Asia
Idioma:
En
Revista:
Ann Plast Surg
Ano de publicação:
2021
Tipo de documento:
Article