Safety begins with correct feeding protocols, so as to prevent aspiration of milk in to the lungs , leading to recurrent chest infections.
At this stage ,the orthodontist might pitch in by fabricating a feeding plate or a Hotz plate or the more recent Nasoalveolar moulding device.
A complete pediatric workup is done along with a detailed look at the child both by the surgeon and the specialist anesthetist.
Surgical Safety:
- General nutritional and hematological status of the patient
- Special emphasis to look for other associated congenital anomalies involving heart , eyes and other organs
- Establishing the complete absence of any prevailing infection prior to surgery
- Assessment of the airway
- Using sophisticated techniques like fibre Optic intubation where needed
- Using the latest pain control and anesthetic agents which act for short periods of time
- For older patients Hypotensive anesthesia is maintained to minimize blood loss, especially for extremely major complex crania facial surgeries.
- Generally routine CLP operations do not require any blood transfusions
- Recovery of patients is always in the relevant pediatric or surgical ICU
- Patient is shifted to the ward only after satisfactory recovery assessed by both anesthetist and surgeon concerned
- Generally a liquid diet is maintained for the first few days and the patient shifted to solid food as soon as it is feasible
- In surgery involving the skull, appropriate techniques are used to ensure gentle handling of the brain and the contents of the orbit
- Continuos neurosurgical monitoring is maintained, both, during surgery and in the post operative phase
The minimum standards requirement are ensured in the hospital where the surgery is carried out, this includes dedicated and fully equipped operation theatre, adult and pediatric ICU, wards, surgical equipment etc.
These parameters have to be met prior to a signed contract with the hospital, and this includes the presence of an adequately trained medical and para medical faculty.
