Prospective Study on the Intraoperative Blood Loss in Patients with Cleft Palate Undergoing Furlow's Double Opposing Z-Palatoplasty

Abstract

Background: Blood loss during cleft palate surgery has been investigated in previous research, but there is no report regarding blood loss when performing Furlow's double opposing Z-plasty (DOZ). In the present study, we evaluated intraoperative blood loss in patients with cleft palate who underwent the DOZ procedure. Materials and Methods: Intraoperative blood loss was prospectively investigated in 59 patients undergoing palatoplasty with DOZ by a single surgeon between August 2012 and July 2013. Demographic factors and clinical status, including cleft type and palatal gap, were recorded. Blood loss was evaluated by measuring the change in weight of a suction bottle, suction line, and gauze balls. Results: Mean blood loss was 16.61 ± 10.33 mL, which accounted for 5% of total blood volume. Male sex, older age, severe cleft type, larger palatal gap, relaxed incision, and increased operative time contributed to greater blood loss. The amount of intraoperative bleeding could be predicted by the following equation: Blood loss = -5.64 + 6.18 (male patients) + 7.58 (severe type cleft) + 0.88 X age (months) + 0.84 X palatal gap (mm). Conclusions: We found that the DOZ technique causes mild blood loss, but bleeding amount tended to increase in older male patients with a severe cleft and a larger palatal gap. The use of relaxed incisions during palatoplasty and prolonged operation times also contributed to greater blood loss.