Anaesthesia for repair of cleft lip, maxilla and palate in Nepal

Hoffmann, E.; Dück, M.; Oberthür, André; Paul, Matthias

doi:10.1017/s0265021503231094

Cited by 2 publications

(4 citation statements)

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“…The director of the cleft program (H-.D.P., senior cleft surgeon) spent one and a half years in the hospital as a founding surgeon (1998–1999). 15 Since the establishment of the program, cleft surgery is offered by 2 German teams for a period of 4 weeks in spring and 4 to 8 weeks in fall. The teams consist of 2 qualified cleft surgeons and an anesthesiologist.…”

Section: Methodsmentioning

confidence: 99%

Ten-Year Cleft Surgery in Nepal: Achievements and Lessons Learned for Better Cleft Care Abroad

Roldán¹,

Pape²,

Koch

et al. 2016

Plastic and Reconstructive Surgery - Global Open

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Background:Cleft lip and palate surgery abroad is devoid of global consensus regarding standards of therapy, follow-up, and outcome. Cleft surgery in Nepal during a 10-year sustained program provided the opportunity to inform on the need for such standards.Methods:Medical records were evaluated from the cleft clinic at Sushma Koirala Memorial Hospital, Sankhu, Kathmandu, Nepal, from 1997 to 2007. Four groups were identified for analysis: total cohort, total surgical cohort (TSC), primary program patients (PPP; patients had not been operated on before), and nonprimary program patients (non-PPP; patients operated on elsewhere before). Patient demographics, diagnostic, primary and secondary surgery (corrective surgery), and follow-up were evaluated.Results:One thousand forty-five patients were eligible for surgery. Three hundred twenty-three of 1,045 patients (30.9%) did not seek treatment, although scheduled for surgery. One thousand two hundred one procedures were performed in 722 patients [TSC; 845 PPP (70.4%); 356 non-PPP (29.64%)]. Corrective procedures were performed in 257 of 1,201 [3.5% (30 of 845 procedures in 509 patients) PPP vs 63.7% (227 of 356 procedures in 213 patients) non-PPP]. One hundred six lips were completely reoperated on (1 PPP vs 105 non-PPP), and 42 palates underwent a total revision (5 PPP vs 37 non-PPP). The surgical outcome of the TSC group in terms of complication rate was similar to the one in developed countries.Conclusions:The high rate of corrective surgery reveals the need for global regulatory mechanisms and the need for nongovernmental organizations to introduce strategies for delivering sustained cleft care until achieving full rehabilitation. The World Health Organization should establish standards for cleft care delivered in less developed countries.

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Section: Methodsmentioning

confidence: 99%

Ten-Year Cleft Surgery in Nepal: Achievements and Lessons Learned for Better Cleft Care Abroad

Roldán¹,

Pape²,

Koch

et al. 2016

Plastic and Reconstructive Surgery - Global Open

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“…Delayed presentation occurs when the new parturient has to undertake long, sometimes arduous journeys to reach regional health centers . An initial misdiagnosis may lead to further delay in referral to a tertiary center , and referrals are usually only made when complications arise . For example, vomiting and diarrhea are common problems in populations who do not have access to fresh running water.…”

Section: The Problemsmentioning

confidence: 99%

“…Drugs and equipment essential to provide safe anesthesia for children and particularly neonates are often lacking . The supply of anesthetic gases and drugs is erratic and unreliable .…”

Section: Drugs and Equipmentmentioning

confidence: 99%

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Neonatal anesthesia with limited resources

Bösenberg

2013

Pediatric Anesthesia

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Neonates are the most vulnerable age group in terms of anesthetic risk and perioperative mortality, especially in the developing world. Prematurity, malnutrition, delays in presentation, and sepsis contribute to this risk. Lack of healthcare workers, poorly maintained equipment, limited drug supplies, absence of postoperative intensive care, unreliable water supplies, or electricity are further contributory factors. Trained anesthesiologists with the skills required for pediatric and neonatal anesthesia as well as basic monitoring equipment such as pulse oximetry will go a long way to improve the unacceptably high anesthetic mortality.

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Anaesthesia for repair of cleft lip, maxilla and palate in Nepal

Cited by 2 publications

References 4 publications

Ten-Year Cleft Surgery in Nepal: Achievements and Lessons Learned for Better Cleft Care Abroad

Ten-Year Cleft Surgery in Nepal: Achievements and Lessons Learned for Better Cleft Care Abroad

Neonatal anesthesia with limited resources

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