title: Perioperative corticosteroid reduces hospital stay after fronto-orbital advancement.
abstract: Facial swelling is common after fronto-orbital advancement. Edema and closure of the palpebral fissures can lead to prolonged hospitalization. The purpose of this study was to determine if perioperative corticosteroid shortens hospital stay after this procedure.We retrospectively studied consecutive children younger than 2 years who underwent primary fronto-orbital advancement between 1990 and 2008. Patients were categorized into 2 groups: group 1 patients were not given corticosteroid; group 2 patients received tapered perioperative dexamethasone. Primary outcome variables included length of hospital stay and infection rate.A total of 161 patients were included in the study. Hospitalization was significantly shorter (P = 0.008) for group 2 (n = 65; median duration, 3.0 d) than group 1 (n = 96; median duration, 5.0 d). Infection rates did not differ between groups (group 1, 2.1%; group 2, 1.5%; P = 0.8).Perioperative corticosteroid shortens hospitalization after fronto-orbital advancement without increasing the incidence of postoperative infection. The cost of postoperative hospital care was reduced by 27.2%.
authors.affiliation: Department of Plastic Surgery, Children's Hospital Boston, Harvard Medical School, Children's Hospital Boston, Harvard Medical School, Boston, Massachusetts 02115, USA.
authors.forename: James E
authors.initials: JE
authors.lastname: Clune
authors.forename: Arin K
authors.initials: AK
authors.lastname: Greene
authors.forename: Chao-Yu
authors.initials: CY
authors.lastname: Guo
authors.forename: Lin Lin
authors.initials: LL
authors.lastname: Gao
authors.forename: Sendia
authors.initials: S
authors.lastname: Kim
authors.forename: John G
authors.initials: JG
authors.lastname: Meara
authors.forename: Mark R
authors.initials: MR
authors.lastname: Proctor
authors.forename: John B
authors.initials: JB
authors.lastname: Mulliken
authors.forename: Gary F
authors.initials: GF
authors.lastname: Rogers
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D015331:Cohort Studies; D003399:Craniotomy; D003422:Critical Care; D003907:Dexamethasone / Q000627:therapeutic use*; D005624:Frontal Bone / Q000601:surgery*; D005938:Glucocorticoids / Q000627:therapeutic use*; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007442:Intubation, Intratracheal; D007902:Length of Stay; D009915:Orbit / Q000601:surgery*; D011182:Postoperative Care / Q000191:economics; D011292:Premedication; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D003907:Dexamethasone