Local Wound Care for Primary Cleft Lip Repair

Treatment and Outcomes With use of Topical Hydrogen Peroxide

Amy L. Strong, Allison C. Nauta, Anna Kuang

    Research output: Contribution to journalArticle

    Abstract

    OBJECTIVES: This study highlights and validates a peroxide-based wound healing strategy for treatment of surgically closed facial wounds in a pediatric population. The authors identified pediatric patients undergoing primary cleft lip repair as a specific population to evaluate the outcomes of such a protocol. Through analysis of defined outcome measures, a reliable and reproducible protocol for postoperative wound care following primary cleft lip repair with favorable results is described.

    METHODS: This retrospective study analyzes wound healing outcomes in pediatric patients undergoing primary cleft lip repair from 2006 to 2011 at a tertiary academic center. The wound healing protocol was used in both primary unilateral and bilateral repairs. One hundred fortysix patients between the ages of 0 and 4 years underwent primary cleft lip repair and cleft rhinoplasty by a single, fellowship-trained craniofacial surgeon. Postoperatively, wounds were treated with half-strength hydrogen peroxide and bacitracin, as well as scar massage. Incisional dehiscence, hypertrophic scar formation, discoloration, infection, and reoperation were studied. Outcomes were evaluated in light of parent compliance, demographics, preoperative nasoalveolar molding (PNAM), and diagnosis.

    RESULTS: The authors identified 146 patients for inclusion in this study. There was no wound or incisional dehiscence. One hundred twenty-four patients demonstrated favorable cosmetic outcome. Only 3 (2%) of patients who developed suboptimal outcomes underwent secondary surgical revision (> 1 year after surgery). Demographic differences were not statistically significant, and PNAM treatment did not influence outcomes.

    CONCLUSION: These data validate the use of halfstrength hydrogen peroxide and bacitracin as part of a wound healing strategy in pediatric incisional wounds. The use of hydrogen peroxide produced comparable outcomes to previously published studies utilizing other wound healing strategies and, therefore, these study findings support the further use of this regimen for this particular population.

    Original languageEnglish (US)
    Pages (from-to)319-326
    Number of pages8
    JournalWounds : a compendium of clinical research and practice
    Volume27
    Issue number12
    StatePublished - Dec 1 2015

    Fingerprint

    Cleft Lip
    Hydrogen Peroxide
    Primary Health Care
    Wound Healing
    Wounds and Injuries
    Pediatrics
    Bacitracin
    Reoperation
    Demography
    Population
    Hypertrophic Cicatrix
    Rhinoplasty
    Massage
    Postoperative Care
    Peroxides
    Cosmetics
    Compliance
    Cicatrix
    Retrospective Studies
    Outcome Assessment (Health Care)

    ASJC Scopus subject areas

    • Surgery
    • Medical–Surgical

    Cite this

    Local Wound Care for Primary Cleft Lip Repair : Treatment and Outcomes With use of Topical Hydrogen Peroxide. / Strong, Amy L.; Nauta, Allison C.; Kuang, Anna.

    In: Wounds : a compendium of clinical research and practice, Vol. 27, No. 12, 01.12.2015, p. 319-326.

    Research output: Contribution to journalArticle

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    abstract = "OBJECTIVES: This study highlights and validates a peroxide-based wound healing strategy for treatment of surgically closed facial wounds in a pediatric population. The authors identified pediatric patients undergoing primary cleft lip repair as a specific population to evaluate the outcomes of such a protocol. Through analysis of defined outcome measures, a reliable and reproducible protocol for postoperative wound care following primary cleft lip repair with favorable results is described.METHODS: This retrospective study analyzes wound healing outcomes in pediatric patients undergoing primary cleft lip repair from 2006 to 2011 at a tertiary academic center. The wound healing protocol was used in both primary unilateral and bilateral repairs. One hundred fortysix patients between the ages of 0 and 4 years underwent primary cleft lip repair and cleft rhinoplasty by a single, fellowship-trained craniofacial surgeon. Postoperatively, wounds were treated with half-strength hydrogen peroxide and bacitracin, as well as scar massage. Incisional dehiscence, hypertrophic scar formation, discoloration, infection, and reoperation were studied. Outcomes were evaluated in light of parent compliance, demographics, preoperative nasoalveolar molding (PNAM), and diagnosis.RESULTS: The authors identified 146 patients for inclusion in this study. There was no wound or incisional dehiscence. One hundred twenty-four patients demonstrated favorable cosmetic outcome. Only 3 (2{\%}) of patients who developed suboptimal outcomes underwent secondary surgical revision (> 1 year after surgery). Demographic differences were not statistically significant, and PNAM treatment did not influence outcomes.CONCLUSION: These data validate the use of halfstrength hydrogen peroxide and bacitracin as part of a wound healing strategy in pediatric incisional wounds. The use of hydrogen peroxide produced comparable outcomes to previously published studies utilizing other wound healing strategies and, therefore, these study findings support the further use of this regimen for this particular population.",
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