(Jurnal Plastik Rekonstruksi, 2024.
Vol 11.
No 2, 44-.
CRANIOFACIAL Article BOTTLE VERSUS SYRINGE FEEDING AFTER PALATOPLASTY: A SYSTEMATIC REVIEW Lucky Permana1.
Kristaninta Bangun2.
Clara Menna2, & Rizky Amaliah3 Department of Surgery.
Cipto Mangunkusumo Hospital / Faculty of Medicine.
Universitas Indonesia.
Jakarta.
Indonesia Division of Plastic Surgery.
Department of Surgery.
Cipto Mangunkusumo Hospital/ Faculty of Medicine.
Universitas Indonesia.
Jakarta.
Indonesia Division of Pediatric Surgery.
Department of Surgery.
Cipto Mangunkusumo Hospital/ Faculty of Medicine.
Universitas Indonesia.
Jakarta.
Indonesia.
ABSTRACT
Introduction : Postoperative feeding after palatoplasty should be initiated immediately to maintain nutritional intake while preserving the palatal sutures to avoid trauma or tension that can lead to wound rupture.
Currently, there is no consensus on post-palatoplasty preferred feeding method.
This study aims to compare bottle versus syringe feeding in post-palatoplasty patients.
Method : A systematic search was conducted in five databases namely PubMed.
Embase.
Scopus.
ProQuest, and CINAHL, with the following keywords.
palatoplasty, cleft palate repair, bottle feeding, syringe feeding, outcome, complication, growth, and nutrition.
The selected studies were critically appraised using the Oxford CEBM (Centre for Evidence-Based Medicin.
critical appraisal tools.
Result : Two studies were included, with a total of 162 subjects.
Both studies found that the formation of postoperative wound dehiscence and weight gain did not significantly differ between bottle and syringe groups.
However, faster weight gain was observed in the bottle group.
Habits and cultural factors could influence the outcomes of these studies.
Conclusion: Bottle feeding is not significantly inferior to using syringe in terms of short-term postoperative complications, and can be used as an alternative feeding method for post-palatoplasty patients.
Keywords: Cleft palate.
Palatoplasty.
Feeding.
Syringe.
Bottle Latar Belakang: Pemberian makan pasca operasi palatoplasti harus dimulai segera untuk mempertahankan asupan nutrisi sekaligus menjaga jahitan palatal agar terhindar dari trauma atau tegangan yang dapat menyebabkan ruptur luka.
Saat ini, belum ada konsensus mengenai metode pemberian makan yang disarankan setelah Penelitian ini bertujuan untuk membandingkan pemberian makan menggunakan botol dengan pemberian makan menggunakan syringe pada pasien pasca palatoplasti.
Metode: Pencarian sistematis dilakukan pada lima basis data, yaitu PubMed.
Embase.
Scopus.
ProQuest, dan CINAHL, dengan kata kunci berikut: palatoplasty, cleft palate repair, bottle feeding, syringe feeding, outcome, complication, growth, dan nutrition.
Studi yang terpilih dinilai secara kritis menggunakan alat penilaian kritis Oxford CEBM (Centre for Evidence-Based Medicin.
Hasil: Dua studi dengan total 162 subjek dimasukkan dalam analisis.
Kedua studi tersebut menunjukkan bahwa kejadian dehiscence luka pasca operasi dan peningkatan berat badan tidak berbeda secara signifikan antara kelompok botol dan syringe.
Namun, peningkatan berat badan yang lebih cepat diamati pada kelompok botol.
Kebiasaan dan faktor budaya dapat memengaruhi hasil dari studi-studi ini.
Kesimpulan: Pemberian makan menggunakan botol tidak secara signifikan lebih rendah dibandingkan penggunaan syringe dalam hal komplikasi pasca operasi jangka pendek, dan dapat digunakan sebagai metode alternatif pemberian makan bagi pasien pasca palatoplasti.
Kata Kunci: Langit-Langit Sumbing.
Palatoplasti.
Pemberian Makan.
Syringe.
Botol Conflicts of Interest Statement:
The author.
listed in this manuscript declare the absence of any conflict of interest on the subject matter or materials discussed.
Received: 03-01-2024.
Revised: 17-08-2024.
Accepted: 28-08-2024 Copyright by Permana.
Bangun.
Menna.
, & Amaliah.
iC P-ISSN 2089-6492.
E-ISSN 2089-9734 iC DOI: 10.
14228/jprjournal.
Published by Lingkar Studi Bedah Plastik Foundation.
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.
0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited.
The work cannot be changed in any way or used commercially without permission from the journal.
This Article can be viewed at w.
Bottle versus syringe feeding after palatoplastyA Jurnal Plastik Rekonstruksi.
Vol.
No.
2, 2024
INTRODUCTION
METHOD
Cleft lip and palate (CLP) are the most common congenital craniofacial abnormalities found in the world.
The prevalence of cleft lip and palate is 0.
3 and 0.
33 in a thousand live births 1 In Indonesia, the incidence of cleft lip and cleft palate is estimated at 1-2 cases per thousand live births.
This systematic review was carried out by 3 different authors (LP.
RA.
KB) on August to December 2023.
Due to the nature of this study, an ethical clearance was not required.
The three researchers contributed in idea conception, literature search, data extraction, data analysis, and manuscript writing.
The systematic review was conducted according to the protocol recommended by the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement.
The review was carried out on PubMed.
Embase.
Scopus.
ProQuest and CINAHL Keywords used for primary search were Aucleft palateAy.
AupalatoplastyAy.
Aucleft palate repairAy.
Aubottle feedingAy.
Ausyringe feedingAy.
AuoutcomeAy.
AucomplicationAy.
AugrowthAy, and AunutritionAy.
Inclusion criteria are systematic reviews, randomized clinical trials (RCT), cohorts and cross-sectional available in English.
The studies must have a population of children 0-24 months old divided into groups of different feeding methods .
ottle feeding vs.
syringe feedin.
and observed for short-term palatoplasty outcomes, namely wound dehiscence and weight gain in the first 90 days after surgery.
Primary outcomes should include short-term post-palatoplasty outcomes, specifically wound dehiscence and weight gain within the first 90 days post-surgery.
Secondary outcomes include post operative complications such as fistula formation.
Exclusion criteria include case series, case reports, studies not directly comparing feeding methods, and those that did not mention shortterm post-palatoplasty outcomes.
After study selection, critical appraisal on case-control and cohort studies was carried out with the Newcastle-Ottawa Scale (NOS),14 nonrandomized intervention studies were assessed with ROBINS-I,15 and randomized studies were assessed using Cochrane RoB 2.
Children with cleft palate are at risk of speech, hearing, and social development disorders, as well as malnutrition.
3Ae5 Timely surgery and multidisciplinary care play an important role in preventing morbidity and Postoperatively, nutrition is important for recovery.
After palatal surgery, the sutured wounds may be ruptured.
This is generally caused by tension on wound closure, poor compliance with postoperative care and wound infection.
Feeding techniques after cleft palate surgery can vary greatly, especially after palatoplasty.
The method of feeding is directly related to shortterm complications including suture integrity.
Food administration via syringe .
yringe feedin.
and pacifiers .
ottle feedin.
are the two most popular methods.
In our center, giving milk via breastfeeding or pacifier is generally not recommended immediately after palatoplasty, due to the hypothesized increase of pressure on the surgical scar, triggering the formation of dehisence or fistulas.
8,9 Feeding via syringe can increase the risk of rejection from the baby, inhibiting adequate nutrition and possibly impeding growth.
10 Augsornwan et al in their study revealed that despite the risk of increasing the possibility of post-operative complications, babies who were fed with breast milk or postpalatoplasty pacifiers were calmer in receiving food compared to using a spoon or syringe, enabling adequate nutrition.
11 There is no consensus or guideline regarding the feeding method after palatoplasty.
9,12
This systematic review aims to compare short-term outcomes .
hort-term weight gain and wound dehisenc.
between pacifier feeding and syringe feeding in babes post-palatoplasty.
The findings from this systematic review can provide guidelines for the preffered method of feeding after palatoplasty.
RESULTS
Figure 1 presents the PRISMA flow diagram of the study.
A total of 648 studies were screened, and 642 were excluded due to irrelevance.
Six studies were retrieved, but three studies were excluded due to being literature reviews and Copyright by Permana.
Bangun.
Menna.
, & Amaliah.
P-ISSN 2089-6492.
E-ISSN 2089-9734 iC DOI: 10.
14228/jprjournal.
This work is licensed under a Creative Commons License Attribution-Noncommercial No Derivative 4.
Jurnal Plastik Rekonstruksi.
Vol.
No.
2, 2024
Permana.
Bangun.
Menna.
, & Amaliah, .
irrelevance, resulting in a total of three studies assessed for eligiblity.
One study was not available in full-text and was excluded from this Searching through website revealed three studies which were ineligible for this review, hence was excluded.
Only two studies were included in the review.
Kim et al18 reported one case of dehisence in the bottle group which healed immediately after conservative management.
The number of oronasal fistula cases in the bottle and syringe group .
and the average complication .
9% vs 12.
5%) was not significantly different.
Qualitative analysis on weight gain revealed contrasting results between the two studies.
Kim et al18 reported no significant difference in relative weight gain within the first and second months after surgery, while Cohen et al17 observed better weight gain in the bottle group.
Kim et al18 also mentioned increased oral intake in the bottle group after the 6th postoperative day.
DISCUSSION