Is cleft lip repair in older children associated with higher complication rates? A postpandemic review

Objective: Cleft lip repair is undertaken in the U.K between the age of 3-6 months according to the “OSLO” protocol. During the COVID19 pandemic all cleft surgical activity was suspended leading to a backlog. With the return of surgical activity, we were operating on children much older than we normally would. This meant that the children were a lot more mobile, traumatising their lip repairs due to an increase in incidents of falls. We would like to present the impact of delays in cleft lip repairs at our centre, due to the COVID-19 pandemic. Patients and Methods: A retrospective review of patients undergoing primary cleft lip repair was performed for patients between 2020-2022 Aug (COVID19 pandemic). To compare the outcomes, we also collected data from patients operated between 2018 and 2019. The Fisher exact test was used to explore statistical difference in surgical outcomes between the two groups of cleft lip patients. Results: During the pandemic 100% of the patients undergoing primary lip repair were over the age of 6 months compared to 16% (8/50) in the pre-pandemic group. In the pandemic group, the parents of 12 children (21%) reported an incident causing trauma to the lip repair. The p value using the Fisher exact test was 0.0037, which was significant at p < 0.05 confirming a higher incidence of falls in older children. Conclusions: We conclude from this study that cleft lip surgery performed in older children has the potential to cause significant and unwanted complications.