The use of throat packs in pediatric cleft lip/palate surgery: a retrospective study

• Published in: Clinical oral investigations 2018-12, Vol.22 (9), p.3053-3059
• Main Authors: Smarius, B. J. A., Guillaume, C. H. A. L., Jonker, G., van der Molen, A. B. Mink, Breugem, C. C.
• Format: Article
• Language: English
• Subjects: Adolescent; Airway Management - instrumentation; Child; Child, Preschool; Children; Cleft Lip - surgery; Cleft lip/palate; Cleft Palate - surgery; Dehiscence; Dentistry; Extubation; Female; Fever; Humans; Infant; Infections; Length of Stay - statistics & numerical data; Male; Medicine; Original; Original Article; Packaging; Packing; Pharynx; Postoperative Complications - epidemiology; Postoperative Complications - prevention & control; Respiratory tract diseases; Retrospective Studies; Surgery; Treatment Outcome
• ISSN: 1432-6981; 1436-3771
• DOI: 10.1007/s00784-018-2387-0

Objectives Throat packs are commonly used to prevent ingestion or aspiration of blood and other debris during cleft lip/palate surgery. However, dislodgement or (partial) retainment after extubation could have serious consequences. The aim of the present study was to investigate the effect of omitting pharyngeal packing during cleft lip/palate surgery on the incidence of early postoperative complications in children. Materials and methods A retrospective study was performed on all children who underwent cleft lip/palate surgery at the Wilhelmina Children’s Hospital. This study compared the period January 2010 through December 2012 when pharyngeal packing was applied according to local protocol (group A) with the period January 2013 till December 2015 when pharyngeal packing was no longer applied after removal from the protocol (group B). Data were collected for sex, age at operation, cleft lip/palate type, type of repair, lateral incisions, length of hospital stay, and complications in the first 6 weeks after surgery. Early complications included wound dehiscence, postoperative bleeding, infection, fever, upper respiratory tract infection (URTI), and lower respiratory tract infection (LRTI). Results This study included 489 cleft lip/palate operations (group A n  = 246, group B n  = 243). A total of 39 (15.9%) early complications were recorded in group A and a total of 40 (16.5%) in group B. There were no significant differences ( P  = 0.902) in complications between the two groups; however, there was a significant difference ( P