title: Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 3. Descriptive study of postoperative nursing care following first stage cleft closure.
abstract: BACKGROUND
  Cleft lip and palate is one of the most common congenital anomalies requiring surgical treatment in children, normally commenced in the first year of life. Following the initiation of a group of multicentre surgical trials of primary surgery, variations in postoperative recovery and management became apparent. An agreement was made for a nurse-led survey in eight surgical centres to document postoperative care and recovery.
  
  
  METHODS
  A postoperative recovery clinical report form was developed to capture relevant data for the children participating in the four arms of the trials. This included the age and weight at admission, the postoperative recovery setting, pain management, postoperative feeding, post-operative complications, and length of hospital stay.
  
  
  RESULTS
  Four hundred and three nursing forms from the first surgical procedure were returned for analysis. Differences in important aspects of care such as postoperative analgesia and postoperative feeding were evident. Postoperative care was influenced by local custom and practice, as little firm clinical evidence exists to guide optimal management.
  
  
  CONCLUSIONS
  Postoperative recovery may play a significant role in the future selection of surgical protocols, and future trials need to consider cross-study site training to familiarise nurses, prior to any changes in surgical methods.
  
  
  BACKGROUND
  ISRCTN29932826.
authors.affiliation: a Dental School, University of Manchester , Manchester , UK.
authors.forename: Patricia
authors.initials: P
authors.lastname: Bannister
authors.affiliation: b Department of Plastic and Reconstructive Surgery , Oslo University Hospital, Rikshospitalet , Oslo , Norway.
authors.forename: Nina
authors.initials: N
authors.lastname: Lindberg
authors.affiliation: c Copenhagen Cleft Palate Center , University Hospital of Copenhagen , Copenhagen , Denmark.
authors.forename: Karin
authors.initials: K
authors.lastname: Jeppesen
authors.affiliation: d Cleft Palate and Craniofacial Center , Helsinki University Central Hospital , Helsinki , Finland.
authors.forename: Ulla
authors.initials: U
authors.lastname: Elfving-Little
authors.affiliation: e Division of Surgery and Clinical Neuroscience , Oslo University Hospital , Oslo , Norway.
authors.forename: Ann-Margritt
authors.initials: AM
authors.lastname: Semmingsen
authors.affiliation: f Department of Plastic Surgery , Sahlgrenska Academy, University of Gothenburg , Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Paganini
authors.affiliation: g Maxillofacial Unit , University Hospital , Linköping , Sweden.
authors.forename: Annica
authors.initials: A
authors.lastname: Gustavsson
authors.affiliation: h Royal Belfast Hospital for Sick Children , Belfast , Northern Ireland , UK.
authors.forename: Emma
authors.initials: E
authors.lastname: Slevin
authors.affiliation: i Center for Cleft Lip and Palate , Haukeland University Hospital , Bergen , Norway.
authors.forename: Gry
authors.initials: G
authors.lastname: Jacobsen
authors.affiliation: a Dental School, University of Manchester , Manchester , UK.
authors.forename: Phil
authors.initials: P
authors.lastname: Eyres
authors.affiliation: a Dental School, University of Manchester , Manchester , UK.|j Department of Plastic and Reconstructive Surgery , Oslo University of Hospital Rikshospitalet, and Statped, Sørøst , Oslo , Norway.
authors.forename: Gunvor
authors.initials: G
authors.lastname: Semb
mesh_terms: D000700:Analgesics / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002971:Cleft Lip / Q000175:diagnosis / Q000451:nursing / Q000601:surgery*; D002972:Cleft Palate / Q000175:diagnosis / Q000451:nursing / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D010149:Postoperative Pain / Q000188:drug therapy* / Q000503:physiopathology; D011182:Postoperative Care / Q000379:methods / Q000451:nursing*; D016032:Randomized Controlled Trials as Topic; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D020127:Recovery of Function; D012537:Scandinavian and Nordic Countries; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
chemical_list: D000700:Analgesics
keywords: Randomised controlled trials; Scandcleft; multicentre study; nursing care following primary surgery; unilateral cleft lip and palate