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

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.