The study was conducted in the Department of
Plastic surgery of a tertiary care center in Puducherry. The objective of the
study was to assess the post-operative complications of children who undergo
cleft lip and cleft palate surgery ,to evaluate the effectiveness of the
nursing interventions in management of post-operative complications among
children with cleft lip and cleft palate surgery and to associate the
effectiveness of the nursing interventions in management of post-operative
complications among children with cleft lip and cleft palate surgery with their
selected demographic variables. The sample size for this study consists of 50
children with cleft lip and cleft palate surgery. The Children who underwent
cleft lip and palate surgery and the children age up to 12 year both male and
female children were included in the study. The children assisted by mechanical
ventilator and children age above 12 years where excluded from the study
Development of data collection instrument consists of two sections: Section A:
This section consist of demographic variables of Age, Sex, Occupation, Income,
Religion, Educational qualification, Area of residence, Type of marriage,
Gestational age, Antenatal exposure history of mother, Mode of delivery, Birth
weight, Color of the baby at birth, Number of birth order, Postnatal history of
illness for Mother, Immunization status of the child, Nutritional status of the
child, Types of feeding in first 3 options days post-operative days, Types of
surgery and Presence of other congenital anomalies. The purpose of the study
was explained to each study subject and oral consent was taken. Assurance was
given to the study subject that anonymity of each individual would be
maintained. Section B: The researcher has developed self-administered
questionnaires to assess the post-operative complications of cleft lip and
palate. This section consists of twenty five questions which were asked to find
out history of the child. Each question has given 4 options such as option (a),
options (b), options (c), and options (d). All options of (a) carries score 1,
all options of (b) carries score2 all options of (c) carries score3, all
options of (d) carries score 4 in each questions and the collected data was
analyzed descriptive statistics. The question consist of status of the child in
post operatively such as General condition, Presence of pus in the wound,
Status of body temperature, Level of temperature, Severity of temperature,
Presence of edematous on wound site, Level of pain, Flap separation, Oxygen
saturation, Status of respiration, Rate of respiration, Retraction for
respiration, Presence of cough, Breath sound, Level of respiratory infection,
Color of the wound, Status of gum, Status of lip, status of tongue, discharge
from the wound, approximation of wound margin, Bleeding, Level of bleeding,
status of the child Touches the wound and Nature of Feeding. The description of
the nursing intervention were as follows: 1) Checking vitals 2) Checking spo2,
3) Head elevated at 45°, 4) Check for throat pack removal, 5) Use of a soft
tipped suctioning gently at the sides of the mouth administration of
medication, 6) administration of iv fluids or use of bottle feed and burp
frequently, after 15–30 ml of formula has been given. 7) Cleanse the wound by
giving 5-15ml of water after each feeding , 8)Position on side after feedings,
9)Assess for tenderness, reddened areas, and lesions or presence of secretions,
10)Cleans suture line with normal saline or sterile water if ordered, 10)Apply
the antibiotic cream to suture line as ordered, 11) Use careful hand washing
and sterile technique when working with suture line, 12)Use of a cotton swab to
apply a half strength peroxide solution, 13)Apply the dressing , 14)Wearing of
arm splint The children selected on the first day in the morning with proper
oral concern obtained from parents for research purpose by explaining the
procedure for gaining trust. Collection of demographic information and pre-test
assessment on complication of post-operative of cleft lip and palate surgery.
The nursing intervention is administered to the children, which takes about 30
minutes. The intervention was repeated for same children for 7 days. On day
seven post-test assessment was recorded after administration of nursing
intervention. Postoperative complications that were assessed Bleeding,
aspiration, Oxygen desaturation, Tachycardia, Flap separation, Infection, Pain,
Upper respiratory Tract infection, and Delayed wound healing.