Video Recording Study of Infants Undergoing Primary Cheiloplasty: Are Arm Restraints Really Needed?

2009 ◽  
Vol 46 (5) ◽  
pp. 494-497 ◽  
Author(s):  
Kazuyuki Tokioka ◽  
Susam Park ◽  
Yasushi Sugawara ◽  
Takashi Nakatsuka
Keyword(s):  
Video Recording ◽  
Perioperative Period ◽  
Adhesive Tape ◽  
Friedman Test ◽  
Standard Practice ◽  
Children's Hospital ◽  
Video Recordings ◽  
Children’S Hospital ◽  
Cleft Surgery ◽  
Affected Infant

Objective: Arm restraints are traditionally used during the perioperative period for cleft surgery to prevent the affected infant from damaging the wound, but the benefits of this standard practice have been controversial. To investigate whether the use of arm restraints provides any benefit to the patient, a video recording study of infants undergoing primary cheiloplasty was conducted. Design: Analysis of video recordings of infants undergoing cheiloplasty. Setting: Shizuoka Children's Hospital, Shizuoka, Japan. Patients and Methods: Eight patients who underwent primary cheiloplasty were recorded for 24 hours on the day before the operation, the day of the operation, and the fourth postoperative day. All recordings were examined by the first author, and the frequency and manner of lip touching were evaluated. Results: Although the frequency of touching varied considerably from 2 to 136 times per 24 hours, it was not statistically different among the 3 recording days (Friedman test, p > .05). All infants touched their lips softly and never attempted to manipulate or scratch their wound. None of the patients pinched the stitches or adhesive tape on the wound with their hands. Conclusions: Although the examined infants touched their lips, they never touched them in a manner that would be harmful to the wound. We concluded that arm restraints are unnecessary after primary cheiloplasty if the procedure is performed before the age of 3 or 4 months.

Factors Associated With Delay in Cleft Surgery at a Tertiary Children’s Hospital in a Major US Metropolitan City

2021 ◽  
pp. 105566562198950
Author(s):  
Jacqueline Stoneburner ◽  
Naikhoba C. O. Munabi ◽  
Eric S. Nagengast ◽  
Madeleine S. Williams ◽  
Pedram Goel ◽  
...  
Keyword(s):  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Female Gender ◽  
Hispanic Ethnicity ◽  
Delayed Surgery ◽  
Factors Associated ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Syndromic Diagnosis ◽  
Cleft Surgery

Objective: To identify factors associated with late cleft repair at a US tertiary children’s hospital. Design: Retrospective study of children with CL/P using Children’s Hospital Los Angeles (CHLA) records. Setting: US tertiary children’s hospital. Patients/Participants: Patients undergoing primary CL or CP repair at CHLA from 2009 to 2018. Main Outcome Measures: Proportion of children who had delayed primary CL repair or CP repair using CHLA and American Cleft Palate-Craniofacial Association (ACPA) guidelines and factors associated with late surgery. Results: In total, 805 patients—503 (62.5%) who had CL repair, 302 (37.5%) CP repair—were included. Using CHLA protocol, 14.3% of patients seeking CL repair had delayed surgery. Delay was significantly associated with female gender, non-Hispanic ethnicity, Spanish primary language, government insurance, bilateral cleft, cleft lip and palate (CLP), and syndromic diagnosis. Using ACPA guidelines, 5.4% had delayed surgery. Female gender and syndromic diagnosis were significantly associated with delay and remained significant after adjustment for confounders in multivariate models. For CP repair, 60.3% of patients had delayed surgery using CHLA protocol. Cleft lip and palate diagnosis, complete cleft, syndromic diagnosis, and longer travel distance were significantly associated with delay. Using ACPA guidelines, 28.5% had delayed surgery; however, significant association with patient variables was not consistently observed. Conclusions: Delay in cleft surgery occurs most often for patients seeking CP repair and is associated with female gender, non-Hispanic ethnicity, Spanish language, government insurance, and bilateral CL, CLP, or syndromic diagnoses. Initiatives should aim to optimize cleft surgery delivery for these subpopulations.

Meshed Adhesive Tape for the Treatment of Crushed Fingers in Children

1984 ◽  
Vol 9 (1) ◽  
pp. 41-41 ◽  
Author(s):  
G. DUTHIE ◽  
J. ADAMS
Keyword(s):  
Adhesive Tape ◽  
Children's Hospital ◽  
Children’S Hospital

Over 300 children a year are treated at the Royal Aberdeen Children’s Hospital for crushed finger tips. We estimate that 5.8% of children, under 13 years of age, suffer this injury, mainly in domestic (72.5%) or car doors (12%). The treatment of partial avulsions of pulp with nail dislocation is described.

Use of Standardized Video Recordings to Assess Cleft Surgery Outcome

1996 ◽  
Vol 33 (2) ◽  
pp. 134-142 ◽  
Author(s):  
David G. Morrant ◽  
William C. Shaw
Keyword(s):  
Quality Assurance ◽  
Scoring System ◽  
Video Recording ◽  
Surgical Techniques ◽  
Surgery Outcome ◽  
Video Recordings ◽  
Secondary Deformity ◽  
And Function ◽  
Further Development ◽  
Cleft Surgery

A standardized method of video recording the nasolabial area of children with complete unilateral clefts of the lip and nose is described. Assessment of the outcome of cleft surgery using a scoring system to evaluate the video recordings was carried out by a panel of plastic surgeons familiar with the problems of secondary deformity in cleft patients. Nine features of the appearance and function of the lip and 10 features of the nose appearance were assessed in 30 children, aged 11 to 14 years, from two cleft treatment centers. The reliability of the panel ranged from poor to excellent for different features of the lip and nose. With further development this technique may be useful in quality assurance, intercenter comparisons, or outcome studies of surgical techniques.

Passy-Muir Speaking Valve Use in a Children's Hospital: An Interdisciplinary Approach

2008 ◽  
Vol 18 (2) ◽  
pp. 76-86 ◽  
Author(s):  
Lauren Hofmann ◽  
Joseph Bolton ◽  
Susan Ferry
Keyword(s):  
Tracheostomy Tube ◽  
Pediatric Population ◽  
Interdisciplinary Approach ◽  
Extended Period ◽  
Speech Development ◽  
Tube Placement ◽  
Background Information ◽  
Speaking Valve ◽  
Children's Hospital ◽  
Children’S Hospital

Abstract At The Children's Hospital of Philadelphia (CHOP) we treat many children requiring tracheostomy tube placement. With potential for a tracheostomy tube to be in place for an extended period of time, these children may be at risk for long-term disruption to normal speech development. As such, speaking valves that restore more normal phonation are often key tools in the effort to restore speech and promote more typical language development in this population. However, successful use of speaking valves is frequently more challenging with infant and pediatric patients than with adult patients. The purpose of this article is to review background information related to speaking valves, the indications for one-way valve use, criteria for candidacy, and the benefits of using speaking valves in the pediatric population. This review will emphasize the importance of interdisciplinary collaboration from the perspectives of speech-language pathology and respiratory therapy. Along with the background information, we will present current practices and a case study to illustrate a safe and systematic approach to speaking valve implementation based upon our experiences.

Children’s Hospital of Eastern Ontario Pain Scale

1985 ◽  
Author(s):  
Patrick J. McGrath ◽  
Garry Johnson ◽  
John T. Goodman ◽  
John Schillinger ◽  
Jennifer Dunn ◽  
...  
Keyword(s):  
Pain Scale ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Eastern Ontario

Children's Hospital of Philadelphia—Self-Efficacy Scale--Spanish Version

2018 ◽  
Author(s):  
Anne E. Kazak ◽  
Wei-Ting Hwang ◽  
Fang Fang Chen ◽  
Martha A. Askins ◽  
Olivia Carlson ◽  
...  
Keyword(s):  
Self Efficacy ◽  
Spanish Version ◽  
Children's Hospital ◽  
Children’S Hospital
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