Establishing cleft services in developing countries: Complications of cleft lip and palate surgery in rural areas of Indonesia

Abstract

BackgroundCleft treatment is frequently performed in Indonesia, mostly in charity missions, but without a postoperative protocol it is difficult to establish the risks and complications of cleft treatment. The present study was designed to give an overview of current cleft lip and palate treatment strategies in Indonesia and to assess the complication rates during and after surgery.MethodsThis prospective study evaluated anesthetic, intraoperative surgical, and short-term postoperative complications in patients undergoing primary, secondary, or corrective surgery for cleft lip and palate deformities. The population consisted of 98 non-syndromic cleft patients. The main anesthetic complication that occurred during general anesthesia was high blood pressure, whereas the main intraoperative surgical complication was excessive bleeding and the main early postoperative complication was extremely poor wound hygiene.ResultsIn this study, there were no cases of perioperative or postoperative mortality. However, in 23 (23.4%) of the 98 operations performed, at least one perioperative complication related to anesthesia occurred. The intraoperative and early postoperative complications following cleft lip and/or palate were assessed. There was a significant difference in the complication rate between procedure types (χ2=0.02; P<0.05). However, no relationship was found between perioperative complications related to anesthesia and the occurrence of postoperative complications (χ2=1.00; P>0.05). Nonetheless, a significant difference was found between procedure types regarding perioperative complications and the occurrence of postoperative complications (χ2=0.031; P<0.05).ConclusionsFurther evaluation of these outcomes would help direct patient management toward decreasing the complication rate.

The characteristics and perioperative outcomes of children with orofacial clefts managed at an academic hospital in Johannesburg, South Africa

“…In a study done in a resource-limited setting, local anaesthesia reduced complications [ 20 ]. The complications encountered in our study have been described in other studies, [ 12 , 28 , 29 ] and they were successfully managed. In Burkina Faso no perioperative complications were reported and it was concluded that surgery for orofacial clefts was safe [ 30 ].…”

Clinical interventions and speech outcomes for individuals with submucous cleft palate

“…In these patients, surgical intervention is considered to be the optimal treatment. Because the timing of surgery is generally considered to be an important factor that determines speech outcomes, children who received early surgical intervention had better outcomes [11][12][13][14]. Several studies have suggested that a younger age leads to better results of surgery in children with SMCP, but research on the different effects of treatment depending on the timing of surgery remains insufficient.…”

“…In these patients, surgical intervention is considered to be the optimal treatment. Because the timing of surgery is generally considered to be an important factor that determines speech outcomes, children who received early surgical intervention had better outcomes 11 12 13 14 .…”

Anthropometric Outcome of Primary Unilateral Cleft Lip Repair in Indonesia

“…A more accurate study from 13 teaching hospitals and 1 private children and maternity hospital in Indonesia found the incidence of CLP was 0.49 to 1.23 per 1000 live births (Kadri et al, 1995). Many patients in Indonesia underwent cleft surgery in charity or humanitarian missions (Ruslin et al, 2019). Integrated cleft services are only available in major cities, and one of them is Surabaya CLP Center.…”