Cleft Palate Repair
Definiton
Cleft palate repair – is surgical repair of congentinal defects in the palate
Causes of defects
1. Lack of embryonic development elements of the prepalate (face, lips, premaxilla and incisors)
2. Palate (hard or soft palate, uvula and additional maxillary teeth
Complications
- Nursing or feeding defects
- Speech defects
- Respiratory defects
Time of surgery preferred:
- Before the 2 years old
Procedure
- General anesthesia induction.
- Insertion of endotracheal tube
- Local anesthesia with epinephrine is injected to prevent homeostasis
- Repair of a complete unilateral (prepalatal and palatal) defect incisions are made of the soft palate
- Development of layers of oral mucosa, muscle and nasal mucosa
- Suture replacement are placed on the hard palate
- Optimal bone grafts are done
- Two layers are sutured muscle layers and oral mucosa
Nursing Considerations in preparing the patient
- The patient must be restrained properly since the table may be in reverse Trendelenburg position
- Keep the patient’s temperature well regulated since the patient’s body surface area is small
- Assist the surgeon in extending the head of the bed during the procedure
- Always observe aseptic technique during the surgery
- Minimize skin exposure as much as possible during the surgery
Nursing Considerations after the procedure
- Place comfortably the patient on his or her sides
- Use restraints on elbow level to prevent ample movement of the child
- Hydrate the child using cups instead of bottles, as well as to clean suture lines
- Support proper positioning by holding the child while feeding sessions to prevent aspiration.
Nursing Care Plan
AssessmentHealth perception and management
Nutrition and metabolism
Physical findings General appearance and nutrition
Eyes, ears, nose, and throat
Gastrointestinal
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