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Objective: This study examines an Enhanced Recovery After Surgery (ERAS) protocol for patients with cleft palate and hypothesizes that patients who followed the protocol would have decreased hospital length of stay and decreased narcotic usage than those who did not.
Design: Retrospective cohort study.
Setting: The study takes place at a single tertiary children's hospital.
Patients: All patients who underwent cleft palate repair during a 10-year period (n = 242).
Interventions: All patients underwent cleft palate repair with the most recent cohort following a new ERAS protocol.
Main Outcome Measures: Primary outcomes included hospital length of stay and narcotic usage in the first 24 hours after surgery.
Results: Use of local bupivacaine during surgery was associated with decreased initial 24-hour morphine equivalent usage: 2.25 vs 3.38 mg morphine equivalent (MME) (P < 0.01), and a decreased hospital length of stay: 1.71 days vs 2.27 days (P < 0.01). The highest 24-hour morphine equivalent a patient consumed prior to the ERAS protocol implementation was 24.53 MME, compared with 6.3 MME after implementation. Utilization of the ERAS protocol was found to be associated with a decreased hospital length of stay: 1.67 vs 2.18 days (P < 0.01).
Conclusions: Use of the proposed ERAS protocol may lead to lower narcotic usage and decreased length of stay.
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http://dx.doi.org/10.1097/SAP.0000000000003951 | DOI Listing |
Wounds
August 2025
Solventum, Maplewood, MN, USA.
Background: Initially limited to inpatient use, negative pressure wound therapy (NPWT) is now frequently used in community settings. However, complexities in wound management step-down strategies in the United Kingdom, including regional variations in referral processes, lack of consensus on funding criteria, and limited availability of NPWT units, have led to extended hospital length of stay (LOS) for patients ready for discharge but still needing NPWT. Single-use NPWT (sNPWT) can serve as a bridge between hospital and community NPWT.
View Article and Find Full Text PDFGen Thorac Cardiovasc Surg
September 2025
Thoracic Surgery Department, Centre Hospitalier de la Cote Basque, 13, avenue de l'Interne Jacques Loeb, 64100, Bayonne, France.
Objective: Reduction of bleeding and prolonged air leak (>5 days) following major lung resection remains a challenge. Hemostasis and aerostasis devices can facilitate earlier pleural de-drainage and fast-track. Our objectives were to evaluate the efficacy of TenaTac (an elastic, adhering patch approved as a medical device) in reducing bleeding and prolonged air leak after major lung resection.
View Article and Find Full Text PDFJ Robot Surg
September 2025
Department of Pediatric Surgery, Affiliated Hospital of North Sichuan Medical College (Wenhua Road Campus), No. 57, Section 2 of Wenhua Road, Shunqing District, Nanchong City, 637000, Sichuan Province, People's Republic of China.
This study aims to systematically assess the therapeutic effectiveness of TiRobot-assisted percutaneous kyphoplasty or vertebroplasty in managing osteoporotic thoracolumbar compression fractures. Previous studies have suggested that TiRobot-assisted techniques outperform conventional manual procedures in treating this condition, but relevant conclusions remain controversial. A thorough literature retrieval was carried out across 4 major databases: PubMed, Embase, the Cochrane Library, and Web of Science.
View Article and Find Full Text PDFPediatr Cardiol
September 2025
Division of Cardiology, Children's National Hospital, 111 Michigan Ave, Washington, DC, 20010, USA.
Patients with acquired and congenital heart disease (CHD) are at higher risk of hospitalization. Despite quality improvement (QI) initiatives, many patients experience readmission soon after discharge. We aimed to identify risk factors for 30-day readmission and hypothesized that direct discharge from the cardiac intensive care unit (CICU) is associated with an increased readmission rate.
View Article and Find Full Text PDFSurg Endosc
September 2025
Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Background: Minimally invasive pancreaticoduodenectomy (MIPD) is used more commonly, but this surge is mostly based on observational data. This meta-analysis aimed to compare the short-term outcomes between MIPD and open pancreaticoduodenectomy (OPD) using data collected from randomized controlled trials (RCTs).
Methods: We searched PubMed, Cochrane Library, Embase, and Web of Science databases for RCTs comparing MIPD and OPD published before December 10, 2024.