Abstract
Purpose. This study examines whether the use of elbow restraints after cleft 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 cleft lip/palate at Akron Children’s Hospital with Institutional Review Board approval. The children were randomized into intervention or control groups with use of elbow restraints considered the intervention. The study consists of two arms; one examined children after cleft lip repair, the second examined children after cleft 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 pacifier or finger/thumb sucking, and postoperative complications including disruption of the suture line. Results. With 47 post palate repair patients and 47 post cleft repair patients, there is no significant difference () in the occurrence of postoperative complications. Conclusions. Study results provide prospective evidence to support postoperative observation of children by surgery staff and family following cleft lip or cleft palate repair without the use of elbow restraints. Clinicians should reevaluate the use of elbow restraints after cleft lip/palate repair based on the belief restraints prevent postoperative complications.
Highlights
E question of whether children require elbow restraints following cle lip and palate repair is unresolved. e theory is that arm restraints prevent children from putting their ngers or objects into their mouth where they could disrupt the suture line
Is approach has been generally accepted as good practice; Jiginni et al [1] in 1993 found no statistically signi cant difference between the use or nonuse of arm restraints in the development of postoperative complications. is is the only evidence-based evaluation in the medical literature
On this basis we conducted a prospective clinical trial to bridge the gap that still remains between practice and evidence based medicine in the use of arm restraints to prevent postoperative complications following cle lip and palate repair
Summary
E question of whether children require elbow restraints following cle lip and palate repair is unresolved. e theory is that arm restraints prevent children from putting their ngers or objects into their mouth where they could disrupt the suture line. In a survey of plastic surgeons in the United Kingdom in 1993, 93% of plastic surgeons reported the use of arm restraints a er repair [1]. With family centered care practiced in the majority of pediatric hospitals parents should be given evidence-based medical results in order to be able to make informed decision on the use of restraints for their child postoperatively. On this basis we conducted a prospective clinical trial to bridge the gap that still remains between practice and evidence based medicine in the use of arm restraints to prevent postoperative complications following cle lip and palate repair
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