Video recording study of infants undergoing primary cheiloplasty: are arm restraints really needed?

OBJECTIVE

Arm restraints are traditionally used during the perioperative period for cleft surgery to prevent the affected infant from damaging the wound, but the benefits of this standard practice have been controversial. To investigate whether the use of arm restraints provides any benefit to the patient, a video recording study of infants undergoing primary cheiloplasty was conducted.

DESIGN

Analysis of video recordings of infants undergoing cheiloplasty.

SETTING

Shizuoka Children's Hospital, Shizuoka, Japan.

PATIENTS AND

METHODS

Eight patients who underwent primary cheiloplasty were recorded for 24 hours on the day before the operation, the day of the operation, and the fourth postoperative day. All recordings were examined by the first author, and the frequency and manner of lip touching were evaluated.

RESULTS

Although the frequency of touching varied considerably from 2 to 136 times per 24 hours, it was not statistically different among the 3 recording days (Friedman test, p > .05). All infants touched their lips softly and never attempted to manipulate or scratch their wound. None of the patients pinched the stitches or adhesive tape on the wound with their hands.

CONCLUSIONS

Although the examined infants touched their lips, they never touched them in a manner that would be harmful to the wound. We concluded that arm restraints are unnecessary after primary cheiloplasty if the procedure is performed before the age of 3 or 4 months.