Patient Safety and Quality Improvement Initiatives in Cleft Lip and Palate Surgery: A Systematic Review.
| Autor: | Grue B; Faculty of Medicine, Dalhousie University., McGuire C; Division of Plastic Surgery, Dalhousie University., Hong P; Division of Otolaryngology, Dalhousie University, Halifax, Nova Scotia, Canada., Bezuhly M; Division of Plastic Surgery, Dalhousie University. |
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| Jazyk: | angličtina |
| Zdroj: | The Journal of craniofacial surgery [J Craniofac Surg] 2023 May 01; Vol. 34 (3), pp. 979-986. Date of Electronic Publication: 2022 Oct 31. |
| DOI: | 10.1097/SCS.0000000000009094 |
| Abstrakt: | Background: Cleft lip and/or palate repair techniques require continued reevaluation of best practice through high-quality evidence. The objective of this systematic review was to highlight the existing evidence for patient safety and quality improvement (QI) initiatives in cleft lip and palate surgery. Methods: A systematic review of published literature evaluating patient safety and QI in patients with cleft lip and/or palate was conducted from database inception to June 9, 2022, using Preferred Reporting Items for Systematic Reviews guidelines. Quality appraisal of included studies was conducted using Methodological Index for Non-Randomized Studies, Cochrane, or a Measurement Tool to Assess Systematic Reviews (AMSTAR) 2 instruments, according to study type. Results: Sixty-one studies met inclusion criteria, with most published between 2010 and 2020 (63.9%). Randomized controlled trials represented the most common study design (37.7%). Half of all included studies were related to the topic of pain and analgesia, with many supporting the use of infraorbital nerve block using 0.25% bupivacaine. The second most common intervention examined was use of perioperative antibiotics in reducing fistula and infection (11.5%). Other studies examined optimal age and closure material for cleft lip repair, early recovery after surgery protocols, interventions to reduce blood loss, and safety of outpatient surgery. Conclusions: Patient safety and QI studies in cleft surgery were of moderate quality overall and covered a wide range of interventions. To further enhance PS in cleft repair, more high-quality research in the areas of perioperative pharmaceutical usage, appropriate wound closure materials, and optimal surgical timing are needed. Competing Interests: The authors report no conflicts of interest. (Copyright © 2022 by Mutaz B. Habal, MD.) |
| Databáze: | MEDLINE |
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