Cleft lip repair with subcuticular closure at National Orthopaedic Hospital, Enugu: Is there any advantage?

Background : Skin closure in unilateral cheiloplasty with non absorbable sutures is commonly practiced, resulting in longer hospitalisation and another anaesthetic session for suture removal in children; increasing costs and risks. Subcuticular suturing obviates crosshatching and may also result in a finer scar, an advantage in patients with oily pigmented skins. Subcuticular closure became routine in the hospital in 2004. This five year study was undertaken to verify if subcuticular closure in unilateral cleft lip surgery reduced the burden of care. Patients and methods : Consecutive patients with unilateral cleft lip repaired at the National Orthopaedic Hospital, Enugu from January 2004 to December 2008 were studied retrospectively. There were 33 patients with subcuticular sutures and 84 with skin sutures. The follow up was a month to four years. Result : Patients with skin suture had 124 surgical sessions and a mean of 7.11 days after surgery before discharge; and those with subcuticular sutures spent a mean of 2.43 days after surgery before discharge. Complications were similar in both groups. Subcuticular closure was associated with reduced hospitalisation time and anaesthetic sessions; reduced risks, costs, and burden of care. Conclusion : The technique of subcuticular suturing may be considered as a viable alternative to non absorbable skin sutures.