The Use of Postoperative Restraints in Children after Cleft Lip or Cleft Palate Repair: A Preliminary Report

Abstract

.Purpose. is study examines whether the use of elbow restraints aer cle lip/palate repair has a relationship to postoperative complications. Methods. A comparative descriptive design was used to study a convenience sample of children undergoing repair of cle lip/palate at Akron Children's Hospital with Institutional Review Board approval. e children were randomized into intervention or control groups with use of elbow restraints considered the intervention. e study consists of two arms; one examined children aer cle lip repair, the second examined children aer cle palate repair. Repairs were performed by a single surgeon. Data collected included age, comorbidities, patient discomfort measured by pain score, frequency and duration of pain medications, use of paci�er or �nger/thumb sucking, and postoperative complications including disruption of the suture line. Results. With 47 post palate repair patients and 47 post cle repair patients, there is no signi�cant difference � > 0.05) in the occurrence of postoperative complications. Conclusions. Study results provide prospective evidence to support postoperative observation of children by surgery staff and family following cle lip or cle palate repair without the use of elbow restraints. Clinicians should reevaluate the use of elbow restraints aer cle lip/palate repair based on the belief restraints prevent postoperative complications.

Enhanced Recovery After Cleft Lip Repair: Protocol Development and Implementation in Outreach Settings

“…Katzel et al 27 stated that 85% of cleft care surgeons advocate the use of elbow restraints after surgery. However, Huth et al 40 showed in their study that there was no significant difference in the incidence of postoperative complications among patients without elbow restraints following cleft lip and palate surgery.…”

Perioperative Management of Cleft Lip Repair: A Meta-Analysis and Clinical Practice Guideline

“…Huth et al performed a prospective study (with unclear randomization) of restraints versus no restraints in a total of 47 postoperative cleft lip repairs. They found no differences in lip repair outcomes (Huth et al, 2013).…”

Opioid Prescribing Practices in Cleft Lip and Cleft Palate Reconstruction

“…Arm splinting to prevent injury after cleft surgery has had common support, with routine use in as many as half the cleft surgeons in North America (Petersen & Lehman, 2008). However; more recent studies have found no significant difference in the rate of wound disruption in children who received arm splints after cleft lip or palate repair and those who did not (Michelotti et al, 2012;Huth et al, 2013;Shaye et al, 2015). Furthermore, the lack of significant difference held, even when parents of patients undergoing cleft surgery reported thumb-sucking behavior or pacifier use by patients in the postoperative period.…”