Day Case Cleft Lip Surgery in Lagos, Nigeria

• Published in: The Cleft palate-craniofacial journal Vol. 46; no. 6; pp. 636 - 641
• Main Authors: Ugburo, A. O., Desalu, I., Adekola, A. F., Fadeyibi, I. O.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-11-2009; American Cleft Palate-Craniofacial Association; SAGE PUBLICATIONS, INC
• Subjects: Ambulatory Surgical Procedures; Biological and medical sciences; Cleft Lip - epidemiology; Cleft Lip - surgery; Deformities; Dentistry; Developing Countries; Facial bones, jaws, teeth, parodontium: diseases, semeiology; Female; Humans; Infant; Male; Medical sciences; Nigeria - epidemiology; Non tumoral diseases; Otorhinolaryngology. Stomatology; Plastic surgery; Postoperative Complications - epidemiology; Prospective Studies; Studies; Treatment Outcome; Nigeria; Africa; Lagos Nigeria; Millard repair; cleft lip; day case surgery; Cleft lip; Treatment; Malformation; Stomatology; Surgery; Oral cavity disease; Congenital cleft; Repair; Congenital disease
• ISSN: 1055-6656; 1545-1569
• DOI: 10.1597/07-156.1

Background:
The correction of cleft lip deformity has included overnight admission and postoperative ward admission from 5 to 7 days. In developing countries, increasing cost of treatment and medical insurance and shortage of bed space have led to a reduction in the length of hospitalization or its elimination for some cases of surgery.
Objective:
To assess the feasibility and complications associated with day case cleft lip surgery in our center.
Methods:
A prospective study of patients undergoing day case cleft lip repair at three hospitals from 1995 to 2005.
Results:
A total of 43 patients were seen. Twenty seven (63.8%) were treated as day case, and 16 (37.2%) were operated as inpatients. The mean age for patients treated as day case was 1.32 ± 1.45 years. Fifteen (55.6%) of these patients had severe associated nasal deformities, six (22.2%) had moderate nasal deformity, and four (14.83%) had mild nasal deformity. The only complication was a nasovestibular fistula that occurred in one of the day case patients. From 27 patients operated on as day cases, eight calls were received. Two (7.4%) mothers called to report febrile illness in their children on the first postoperative day. Two mothers (7.4%) reported excessive crying. The most frequent reason for postoperative consultation was obstruction of the modified nasal retainer, which occurred in four patients (14.8%).
Conclusion:
Day case surgery for cleft lip can be said to be safe, with a 2.3% rate of complications in selected patients. Day case surgery was a cheaper alternative to admission.