Is There Utility in Preoperative Testing of Hemoglobin Before Primary Cheiloplasty?

Abstract

Objective To examine whether a preoperative hemoglobin of less than 10 g/dL is associated with a higher rate of perioperative complications. Design Retrospective review. Setting Tertiary academic hospital at Arkansas Children's Hospital of Little Rock, Arkansas. Patients A retrospective chart review evaluated patients undergoing primary cleft lip surgery from 2012 to 2017. Interventions No prospective intervention was performed for this study care. Main Outcome Measures Age, sex, medical history, weight, and perioperative complications. Hemoglobin level was collected in the preoperative area. The primary outcome was rate of perioperative complications including infection, dehiscence, return to the operating room, unplanned admission, and emergency department visit within two weeks postoperatively. Results 105 patients undergoing primary cheiloplasty met inclusion criteria. Hemoglobin levels were obtained on all patients. 93.3% (n = 98) of patients had a hemoglobin of >10 g/dL before surgery, and 6.6% (n = 7) had levels <10 g/dL. 1 of 7 patients with a hemoglobin of <10 g/dL experienced a postoperative complication (Tet spell) and one patient with a hemoglobin of >10 g/dL experienced a postoperative complication (unplanned intensive care admission for respiratory distress). Conclusions Post-operative complications are rare after primary cheiloplasty in patients with low or normal hemoglobin levels. The results of this study show that a preoperative hemoglobin of <10 g/dL does not predict perioperative complications in patients undergoing primary cheiloplasty.