The immediate postoperative care of a child with cleft lip: time-proven suggestions.

An excellent cleft lip repair demands and depends upon good postoperative care. The strain caused by crying can be minimized by eliminating restraints and by early hospital dismissal. Protein and vitamin C are important in healing. A nongreasy pressure dressing capable of absorbing serum is applied for the first night only, then the suture line is sponged with cold water after each feeding. Following suture removal, effective bridging is achieved by applying perforated Zonas adhesive directly to the wound. The care outlined has been used successfully for 93 cleft lip patients over 24 years. Both sides of bilateral clefts were closed at one operation. Two patients among 18 with bilateral clefts had one side break down; 1 patient had a partial breakdown on both sides. This same postoperative routine has been used successfully when operating under less than ideal circumstances in primitive areas. Good postoperative care consists of attention to many little details, none of which are important by themselves but which, when added together, give perfection.