title: Humanitarian Cleft Lip/Palate Surgeries in Buddhist Thailand and Neighboring Countries.
abstract: OBJECTIVE
  This study evaluates surgeries done on patients with cleft lip and/or palate in Thailand and its neighboring countries from 1988 to 2008. This 21-year-long volunteer surgical mission was sponsored by Duang-Kaew Foundation, a volunteer organization. Countries involved, besides Thailand, were Vietnam, Myanmar, Laos, Cambodia, China, Sri Lanka, Bhutan, and India. The same surgical method for primary and secondary repair of lip and/or palate was used throughout: Onizuka method by single surgeon, the second author mainly.
  
  
  METHODS
  We assessed, by way of the patients' medical records including their background, the results of surgeries. The healing rates and complication rates associated with patients for primary and secondary repair of lip and/or palate.
  
  
  METHODS
  The study consisted of a total of 6832 patients: 3120 with cleft lip (CL); 2190 with cleft palate (CP); and 1522 with cleft lip and palate (CLP). Their primary cases were 675 (CL), 799 (CP), and 301 (CLP).
  
  
  RESULTS
  All CP operations were done under general anesthesia. Of the CL surgeries, 10% of adult cases were done under local anesthesia. Of all the patients, 78%, or 5329, had one surgery; and 22%, or 1503, had 2 or more surgeries. Good healing was seen in 73.3%, whereas wound infection was noted in 2.0% and healing by second intention was in 1.2% of all cases.
  
  
  CONCLUSIONS
  It is important that the Onizuka method was the only method used in all the countries throughout the mission period. The method has an advantage over other methods in that its design is simple enough so that even a beginning plastic surgeon can easily master, and operative results are constantly good regardless of who did the operation. The Duang-Kaew Foundation's long-term surgical program helped reduce the number of untreated patients to manageable levels for local health care providers in Thailand and neighboring countries for as long as 21 years.
authors.affiliation: *Department of Plastic and Reconstructive Surgery, Saga University, Saga, Japan †Medical Research ‡Dental Center, Royal Thai Naval Hospital, Bangkok, Thailand.
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Uemura
authors.forename: Piyoros
authors.initials: P
authors.lastname: Preeyanont
authors.forename: Sopridee
authors.initials: S
authors.lastname: Udnoon
mesh_terms: D000328:Adult; D000533:Altruism; D002681:China; D002971:Cleft Lip / Q000601:surgery*; D002972:Cleft Palate / Q000601:surgery*; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008493:Medical Missions / Q000458:organization & administration*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013518:Surgery, Plastic / Q000458:organization & administration*; D013785:Thailand