(Press-News.org) July 10, 2015 - For children with cleft lip and palate, the chances of undergoing secondary surgery vary depending on the center where they're treated, reports a study in Plastic and Reconstructive Surgery--Global Open®, the official open-access medical journal of the American Society of Plastic Surgeons (ASPS).
When secondary surgeries are performed, they don't necessarily improve the child's final facial appearance, according to the new research by ASPS Member Surgeon Dr. Thomas J. Sitzman of Cincinnati Children's Hospital Medical Center and colleagues.
Secondary Cleft Lip and Palate Surgery--Variation and Outcomes
The researchers analyzed 130 children undergoing surgery to repair cleft lip and cleft palate at four specialized centers. The patients were part of the "Americleft" study, designed to compare surgical outcomes across North American cleft palate centers. All patients had cleft lip/cleft palate as their only abnormality, unrelated to any congenital syndrome.
Rates of secondary surgeries--additional procedures performed on the lip, palate, and/or nose after the initial (primary) surgery--were compared across the study centers. Most patients were followed up through adolescence.
The results showed significant variation in rates of secondary lip surgery and secondary nasal surgery (rhinoplasty) at the four cleft palate centers. Through ten years, the estimated rate of secondary lip surgery by center ranged from five percent to 60 percent. There was also substantial variation in rates of secondary rhinoplasty--from 47 to 79 percent by age 20 years.
Overall, the risk of secondary lip surgery varied 12-fold across centers, while the risk of secondary rhinoplasty varied six-fold. There was no significant variation in secondary palate surgery.
Surgeon ratings of follow-up photographs found no significant difference in the final appearance of the nose and lip for patients who had secondary surgery versus primary surgery only. (The researchers emphasize that secondary surgery may have improved outcomes for some children, even though there was no overall difference between groups.)
Secondary surgery for cleft lip and palate adds to the "burden of care" in terms of pain and fear for children and time off work for parents, as well as higher healthcare costs. The results are consistent with a previous European study (Eurocleft) reporting variations in secondary surgery rates.
"This study raises the important question of why variation exists between centers in the use of secondary surgery," Dr. Sitzman and colleagues write. It may be that some centers achieve better results with the initial surgery, or that centers have different thresholds for recommending further surgery. The researchers note that their study didn't include photos to assess the results of the primary surgery.
But regardless of the source of the variation, "The effect is broad differences in a child's burden of surgical care depending upon where they are treated," Dr. Sitzman and coauthors write. They call for further studies to better define the role of secondary surgery for children with cleft lip and palate.
INFORMATION:
Click here to read "The Americleft Project: Burden of Care from Secondary Surgery."
Article: The Americleft Project: Burden of Care from Secondary Surgery. (doi: 10.1097/GOX.0000000000000415)
Plastic and Reconstructive Surgery--Global Open® is published by Lippincott Williams & Wilkins, part of Wolters Kluwer.
About PRS Global Open
Plastic and Reconstructive Surgery--Global Open (http://www.prsgo.com) is a companion journal to the American Society of Plastic Surgeons' flagship publication, Plastic and Reconstructive Surgery. PRS GO is an open access, rigorously peer-reviewed, international journal focusing on global plastic and reconstructive surgery. PRS GO educates and supports plastic surgeons globally to provide the highest quality patient care and maintain professional and ethical standards through education, research, and advocacy.
About ASPS
The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. Representing more than 7,000 physician members, the Society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.
About Wolters Kluwer
Wolters Kluwer is a global leader in professional information services. Professionals in the areas of legal, business, tax, accounting, finance, audit, risk, compliance and healthcare rely on Wolters Kluwer's market leading information-enabled tools and software solutions to manage their business efficiently, deliver results to their clients, and succeed in an ever more dynamic world.
Wolters Kluwer reported 2014 annual revenues of €3.7 billion. The group serves customers in over 170 countries, and employs over 19,000 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands. Wolters Kluwer shares are listed on NYSE Euronext Amsterdam (WKL) and are included in the AEX and Euronext 100 indices. Wolters Kluwer has a sponsored Level 1 American Depositary Receipt program. The ADRs are traded on the over-the-counter market in the U.S. (WTKWY).
For more information about our products and organization, visit http://www.wolterskluwer.com, follow @WKHealth or @Wolters_Kluwer on Twitter, like us on Facebook, follow us on LinkedIn, or follow WoltersKluwerComms on YouTube.
Random-access memory, or RAM, is where computers like to store the data they're working on. A processor can retrieve data from RAM tens of thousands of times more rapidly than it can from the computer's disk drive.
But in the age of big data, data sets are often much too large to fit in a single computer's RAM. The data describing a single human genome would take up the RAM of somewhere between 40 and 100 typical computers.
Flash memory -- the type of memory used by most portable devices -- could provide an alternative to conventional RAM for big-data applications. It's ...
LEXINGTON, Ky. (Jul. 10, 2015) -- Macrophages are cellular sentinels in the body, assigned to identify "attacks" from viruses, bacteria, or fungi and sound the alarm when they are present. However, these cells are a "double edged sword" in spinal cord injury, providing both neural repair-promoting properties and pathological functions that destroy neuronal tissue
"We know from previous research that macrophages are versatile, and signals at the injury site can stimulate repair or destruction--or confusingly, both," said John Gensel Ph.D., Assistant Professor of Physiology ...
This news release is available in Spanish.
Scientists at the Centre for Genomic Regulation (CRG), the research company Starlab and the group BR::AC (Barcelona Research Art & Creation) of the University of Barcelona developed a device that produces sounds from brain signals. This highly interdisciplinary team is led by Mara Dierssen, head of the Cellular & Systems Neurobiology group at CRG. Its ultimate goal is to develop an alternative communication system for people with cerebral palsy to allow them to communicate--and more specifically in this pilot phase, ...
The great white shark (Carcharodon carcharias) has a terrifying reputation. Shark attacks, though very rare, loom large in our imaginations, drawing intense media attention when they occur. Recent injuries in North Carolina are putting sharks in the limelight again. But going after sharks à la Jaws is not the best way to protect people in the water, said shark researchers.
California scientists found that the risk of white shark attack for individual ocean users in California has fallen strikingly, by over 91 percent, since 1950, in a study to be published online ...
Many areas of fundamental research are interested in graphene owing to its exceptional characteristics. It is made of one layer of carbon atoms, which makes it light and sturdy, and it is an excellent thermal and electrical conductor. Its unique features make it potentially suitable for applications in a number of areas . Scientists at EPFL's Bionanophotonic Systems Laboratory (BIOS) together with researchers from ICFO- The Institute of Photonic Sciences in Barcelona, have now harnessed graphene's unique optical and electronic properties to develop a reconfigurable highly ...
Men may feel threatened by female supervisors and act more assertively toward them than male bosses, which could disrupt the workplace with struggles over power dynamics, according to new research published by the Society for Personality and Social Psychology.
"The concept of masculinity is becoming more elusive in society as gender roles blur, with more women taking management positions and becoming the major breadwinners for their families," said lead researcher Ekaterina Netchaeva, an assistant professor of management and technology at Bocconi University in Milan, ...
Heidelberg, 10 July 2015 - Researchers at EMBL Heidelberg have produced detailed images of the intricate protein-coats that surround trafficking vesicles - the "transport pods" that move material around within biological cells. The study, published today in Science, provides a new understanding of the complex machines that make up the cells' logistics network.
Vesicles are responsible for transporting molecules between the different compartments within a cell and also for bringing material into cells from outside. There are several types of vesicle: each has a specific ...
University of Warwick researchers have discovered a cell structure which could help scientists understand why some cancers develop.
For the first time a structure called 'the mesh' has been identified which helps to hold together cells. This discovery, which has been published in the online journal eLife, changes our understanding of the cell's internal scaffolding.
This also has implications for researchers' understanding of cancer cells as the mesh is partly made of a protein which is found to change in certain cancers, such as those of the breast and bladder.
The ...
Treating obese pregnant women with a diabetes drug does not stop their babies from being born overweight, a study has found.
Doctors had hoped that the treatment would help to reduce obesity rates and lower the number of difficult births.
Heavier babies are more likely to grow into overweight adults. They also have a higher risk of illnesses later in life, such as diabetes and heart disease.
It is thought that the additional weight gain in the womb is caused by exposure to excess blood sugar.
Researchers tested whether treating overweight mothers-to-be with the ...
A research team comprising scientists from Tohoku University, RIKEN, the University of Tokyo, Chiba University and University College London have discovered a new chemical reaction pathway on titanium dioxide (TiO2), an important photocatalytic material.
The reaction mechanism, reported in ACS Nano, involves the application of an electric field that narrows the width of the reaction barrier, thereby allowing hydrogen atoms to tunnel away from the surface. This opens the way for the manipulation of the atomic-scale transport channels of hydrogen, which could be important ...
