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Lessons Learned From Two Consecutive Cleft Lip and Palate Missions and the Impact of Patient Education.

Schönmeyr, Björn LU ; Restrepo, Carolina; Wendby, Lisa; Gillenwater, Justin and Campbell, Alex (2014) In Journal of Craniofacial Surgery 25(5). p.1610-1613
Abstract
Two consecutive cleft missions were conducted in Guwahati, northeastern India in December 2010 and January 2011. In the later mission, a standardized patient education program for postoperative care was introduced. The objective of this study was to retrospectively evaluate the impact of the patient education program on cleft lip complications in terms of wound infection and dehiscence. Two hundred ninety-eight cleft lip repairs were performed in the first mission and 220 (74%) returned for early follow-up. In the second mission, 356 patients were operated on and 252 (71%) returned for follow-up. From the first mission, 8 patients (3.7%) were diagnosed with lip wound infection and 21 patients (9.6%) with lip dehiscence. After the second... (More)
Two consecutive cleft missions were conducted in Guwahati, northeastern India in December 2010 and January 2011. In the later mission, a standardized patient education program for postoperative care was introduced. The objective of this study was to retrospectively evaluate the impact of the patient education program on cleft lip complications in terms of wound infection and dehiscence. Two hundred ninety-eight cleft lip repairs were performed in the first mission and 220 (74%) returned for early follow-up. In the second mission, 356 patients were operated on and 252 (71%) returned for follow-up. From the first mission, 8 patients (3.7%) were diagnosed with lip wound infection and 21 patients (9.6%) with lip dehiscence. After the second mission, only 1 patient (0.4%) returned with a wound infection and 16 (6.4%) were diagnosed with dehiscence.Using binary logistic regression including age, cleft type, postoperative antibiotics, surgeon, and patient education program as covariates, the patient education program stood out as the only variable with a statistically significant impact on the incidence of postoperative wound infections. Even though the incidence of lip dehiscence was reduced by one third when the patient education program was utilized, our regression model singled out the surgeons as the only factor significantly related to this type of complication. Moreover, no benefits of postoperative antibiotic prophylaxis were found. Further analysis of the data also implied that the use of tissue adhesive as a compliment to sutures does not reduce the risk of dehiscence. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Craniofacial Surgery
volume
25
issue
5
pages
1610 - 1613
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:25148620
  • wos:000341933600048
  • scopus:84914100389
ISSN
1536-3732
DOI
10.1097/SCS.0000000000000999
language
English
LU publication?
yes
id
be6468ba-07a4-4daa-a043-36ef568cb8db (old id 4614166)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/25148620?dopt=Abstract
date added to LUP
2014-09-08 21:36:23
date last changed
2017-09-10 03:20:49
@article{be6468ba-07a4-4daa-a043-36ef568cb8db,
  abstract     = {Two consecutive cleft missions were conducted in Guwahati, northeastern India in December 2010 and January 2011. In the later mission, a standardized patient education program for postoperative care was introduced. The objective of this study was to retrospectively evaluate the impact of the patient education program on cleft lip complications in terms of wound infection and dehiscence. Two hundred ninety-eight cleft lip repairs were performed in the first mission and 220 (74%) returned for early follow-up. In the second mission, 356 patients were operated on and 252 (71%) returned for follow-up. From the first mission, 8 patients (3.7%) were diagnosed with lip wound infection and 21 patients (9.6%) with lip dehiscence. After the second mission, only 1 patient (0.4%) returned with a wound infection and 16 (6.4%) were diagnosed with dehiscence.Using binary logistic regression including age, cleft type, postoperative antibiotics, surgeon, and patient education program as covariates, the patient education program stood out as the only variable with a statistically significant impact on the incidence of postoperative wound infections. Even though the incidence of lip dehiscence was reduced by one third when the patient education program was utilized, our regression model singled out the surgeons as the only factor significantly related to this type of complication. Moreover, no benefits of postoperative antibiotic prophylaxis were found. Further analysis of the data also implied that the use of tissue adhesive as a compliment to sutures does not reduce the risk of dehiscence.},
  author       = {Schönmeyr, Björn and Restrepo, Carolina and Wendby, Lisa and Gillenwater, Justin and Campbell, Alex},
  issn         = {1536-3732},
  language     = {eng},
  number       = {5},
  pages        = {1610--1613},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Journal of Craniofacial Surgery},
  title        = {Lessons Learned From Two Consecutive Cleft Lip and Palate Missions and the Impact of Patient Education.},
  url          = {http://dx.doi.org/10.1097/SCS.0000000000000999},
  volume       = {25},
  year         = {2014},
}