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CC BY-NC 4.0 · Arch Plast Surg 2019; 46(06): 511-517
DOI: 10.5999/aps.2018.00493
Original Article

Establishing cleft services in developing countries: Complications of cleft lip and palate surgery in rural areas of Indonesia

Muhammad Ruslin   
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia
Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center, Amsterdam, The Netherlands
,
Lawrence Dom 
Department of Anesthesiology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
,
Andi Tajrin 
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia
,
Andi Sitti Hajrah Yusuf   
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Hasanuddin University, Makassar, Indonesia
School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
,
Syafri Kamsul Arif
Department of Anesthesiology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
,
Andi Husni Tanra 
Department of Anesthesiology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
,
Keng Liang Ou 
School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
,
Tymour Forouzanfar
Department of Oral and Maxillofacial Surgery/Oral Pathology, VU University Medical Center, Amsterdam, The Netherlands
,
Sri Astuti Thamrin 
Department of Statistics, Hasanuddin University, Makassar, Indonesia
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Background Cleft treatment is frequently performed in Indonesia, mostly in charity missions, but without a postoperative protocol it is difficult to establish the risks and complications of cleft treatment. The present study was designed to give an overview of current cleft lip and palate treatment strategies in Indonesia and to assess the complication rates during and after surgery.

Methods This prospective study evaluated anesthetic, intraoperative surgical, and short-term postoperative complications in patients undergoing primary, secondary, or corrective surgery for cleft lip and palate deformities. The population consisted of 98 non-syndromic cleft patients. The main anesthetic complication that occurred during general anesthesia was high blood pressure, whereas the main intraoperative surgical complication was excessive bleeding and the main early postoperative complication was extremely poor wound hygiene.

Results In this study, there were no cases of perioperative or postoperative mortality. However, in 23 (23.4%) of the 98 operations performed, at least one perioperative complication related to anesthesia occurred. The intraoperative and early postoperative complications following cleft lip and/or palate were assessed. There was a significant difference in the complication rate between procedure types (χ 2=0.02; P<0.05). However, no relationship was found between perioperative complications related to anesthesia and the occurrence of postoperative complications (χ 2=1.00; P>0.05). Nonetheless, a significant difference was found between procedure types regarding perioperative complications and the occurrence of postoperative complications (χ 2=0.031; P<0.05).

Conclusions Further evaluation of these outcomes would help direct patient management toward decreasing the complication rate.

Keywords

Cleft lip - Cleft palate - Surgery

*The two authors contributed equally to this work.




Publication History

Received: 23 May 2018

Accepted: 31 July 2019

Article published online:
25 March 2022

© 2019. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

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