Comparison of Trends in Treatment Age and Complications After Primary Cleft Lip and Palate Surgery Between Comprehensive and Non Comprehensive Cleft Centers

Objective Cleft lip and palate is the most common craniofacial birth defect. Timely primary cleft surgery is important to achieve good esthetic and speech outcomes and to prevent complications. The aim of this study was to compare outcomes between patients undergoing surgery at a comprehensive cleft center (CCC) and non-CCCs. Design Retrospective comparative study. Settings One CCC and non-CCCs in 5 cities. Patients and Intervention The study included 300 children who underwent primary cleft surgery at the participating centers between 2020 and 2024. Main Outcome Measures The age at primary cleft surgery, length of hospital stay (LoS), and complications. Results Primary cleft-lip and cleft-palate surgery was delayed in >50% and >60% of patients in the non-CCC group, respectively, which was significantly different compared to the rates in the CCC group. LoS was significantly shorter in the non-CCC group ( P = .001). Complications such as bleeding, dehiscence, and return to the operating room after primary cleft surgery were significantly more common in the non-CCC group ( P < .01) Conclusion This study offers an insight into the timing of cleft lip and palate surgery, epidemiology, complication rates, and LoS in CCC and non-CCC settings in Indonesia. The frequency of delayed primary cleft lip and palate surgery and complication rates were significantly higher in non-CCC than in CCC settings. Therefore, strengthening cleft-care infrastructure in remote regions through multidisciplinary training, standardized operative protocols, and improved logistical support is essential to reduce disparities and ensure sustainability.