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The management of post-palatoplasty haemorrhage: A survey of cleft surgeons in Great Britain and Ireland and recommendations for local protocol implementation

Khera, B.; Swan, M. C.; Thorburn, G.; Fell, M. J.

2025-05-11 surgery
10.1101/2025.05.09.25327326 medRxiv
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ObjectiveTo investigate strategies used by cleft surgeons to manage post-palatoplasty haemorrhage. DesignOnline cross-sectional survey SettingGreat Britain and Ireland Participants23 of 36 Cleft Surgeons (64% response rate) Results16% of respondents indicated having a protocol for managing post-operative bleeds. There was an emphasis on the importance of preventative strategies to reduce the risk of post-operative bleeds occurring. Amongst the variety of non-surgical management options, systemic tranexamic acid and direct pressure were considered the most important. The tendency to prescribe antibiotics for secondary bleeds indicates a perceived difference in the nature or risk associated with these compared to primary bleeds. There was agreement that once identified, the management of post-operative bleeds should be proactive with a low threshold to return to theatre in the presence of an active intra-oral bleed. ConclusionsWe suggest a template with considerations that can be adapted into a local haemorrhage protocol for individual cleft units.

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