COMPARISON OF AMBULATORY AND INPATIENT CLEFT LIP SURGERY FOR ADULTS
AbstractBackground: Ambulatory cleft lip repair after its acceptance in developed countries is alsobecoming popular in developing world. This study was performed to compares the outcomes ofambulatory cleft lip repair with the inpatient group for adult patients. Objectives were to compareoutcome after ambulatory and inpatient cleft lip surgery for adults with respect to perioperativecomplications (Early: pain, oedema of upper lip, bleeding, nausea or vomiting, infection,dehiscence; Late: visible scar and white roll discrepancy), to compare the economic benefits, andevaluate patient satisfaction in terms of acceptance for ambulatory surgery. Methods: Thiscomparative study is carried out in Plastic Surgery Department, King Edward Medical University,Mayo Hospital, Lahore. The study included 80 adult patients fulfilling inclusion criteria and wererandomly divided into two groups, i.e., Ambulatory (Group-A, n=40) and Inpatient (Group-B,n=40). Those belonging to ambulatory group were worked up on OPD basis, advised to report onmorning of surgery, operated under loco-regional anaesthesia and were discharged on same day.Patients of inpatient group were admitted two days before surgery, worked up in ward, operatedunder general anaesthesia and were discharged on 2nd day. Results: Ambulatory cleft lip surgerycan be easily performed under loco-regional anaesthesia. Perioperative complications betweenthese groups were comparable. Hospital stay was significantly reduced in ambulatory surgery. Thepatients felt more satisfied after ambulatory than inpatient surgery. Conclusion: Ambulatory cleftlip repair for adults is as safe as inpatient surgery. It is dependable option and can be successfullyperformed in our setup. It should be considered whenever possible due to cost effectiveness,reduction of waiting lists, earlier discharge and better utilisation of hospital resources.Keywords: Cleft lip, Ambulatory surgery, Inpatient surgery, local anaesthesia
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