Patricia Bannister1, Nina Lindberg2, Karin Jeppesen3, Ulla Elfving-Little4, Ann-Margritt Semmingsen5, Anna Paganini6, Annica Gustavsson7, Emma Slevin8, Gry Jacobsen9, Phil Eyres1, Gunvor Semb1,10. 1. a Dental School, University of Manchester , Manchester , UK. 2. b Department of Plastic and Reconstructive Surgery , Oslo University Hospital, Rikshospitalet , Oslo , Norway. 3. c Copenhagen Cleft Palate Center , University Hospital of Copenhagen , Copenhagen , Denmark. 4. d Cleft Palate and Craniofacial Center , Helsinki University Central Hospital , Helsinki , Finland. 5. e Division of Surgery and Clinical Neuroscience , Oslo University Hospital , Oslo , Norway. 6. f Department of Plastic Surgery , Sahlgrenska Academy, University of Gothenburg , Sweden. 7. g Maxillofacial Unit , University Hospital , Linköping , Sweden. 8. h Royal Belfast Hospital for Sick Children , Belfast , Northern Ireland , UK. 9. i Center for Cleft Lip and Palate , Haukeland University Hospital , Bergen , Norway. 10. j Department of Plastic and Reconstructive Surgery , Oslo University of Hospital Rikshospitalet, and Statped, Sørøst , Oslo , Norway.
Abstract
BACKGROUND: Cleft lip and palate is one of the most common congenital anomalies requiring surgical treatment in children, normally commenced in the first year of life. Following the initiation of a group of multicentre surgical trials of primary surgery, variations in postoperative recovery and management became apparent. An agreement was made for a nurse-led survey in eight surgical centres to document postoperative care and recovery. MATERIALS AND METHODS: A postoperative recovery clinical report form was developed to capture relevant data for the children participating in the four arms of the trials. This included the age and weight at admission, the postoperative recovery setting, pain management, postoperative feeding, post-operative complications, and length of hospital stay. RESULTS: Four hundred and three nursing forms from the first surgical procedure were returned for analysis. Differences in important aspects of care such as postoperative analgesia and postoperative feeding were evident. Postoperative care was influenced by local custom and practice, as little firm clinical evidence exists to guide optimal management. CONCLUSION: Postoperative recovery may play a significant role in the future selection of surgical protocols, and future trials need to consider cross-study site training to familiarise nurses, prior to any changes in surgical methods. TRIAL REGISTRATION: ISRCTN29932826.
BACKGROUND:Cleft lip and palate is one of the most common congenital anomalies requiring surgical treatment in children, normally commenced in the first year of life. Following the initiation of a group of multicentre surgical trials of primary surgery, variations in postoperative recovery and management became apparent. An agreement was made for a nurse-led survey in eight surgical centres to document postoperative care and recovery. MATERIALS AND METHODS: A postoperative recovery clinical report form was developed to capture relevant data for the children participating in the four arms of the trials. This included the age and weight at admission, the postoperative recovery setting, pain management, postoperative feeding, post-operative complications, and length of hospital stay. RESULTS: Four hundred and three nursing forms from the first surgical procedure were returned for analysis. Differences in important aspects of care such as postoperative analgesia and postoperative feeding were evident. Postoperative care was influenced by local custom and practice, as little firm clinical evidence exists to guide optimal management. CONCLUSION: Postoperative recovery may play a significant role in the future selection of surgical protocols, and future trials need to consider cross-study site training to familiarise nurses, prior to any changes in surgical methods. TRIAL REGISTRATION: ISRCTN29932826.
Entities:
Keywords:
Randomised controlled trials; Scandcleft; multicentre study; nursing care following primary surgery; unilateral cleft lip and palate