Post-Operative Bleeding After Facial Cleft Repair: A Retrospective Review of TriNetX Database

Introduction: The objective of this article is to assess and describe the incidence of postoperative hemorrhage following cleft palate surgery (palatoplasty), specifically focusing on need for return to the operating room for management of post-operative hemorrhage. Methods: The TriNetX federated database was used to identify patients with a diagnosis of cleft lip and/or palate undergoing primary cleft palate repair over a twenty-year period from 2003 until2023. Primary endpoints assessed include post operative hemorrhage resulting in blood transfusion and/or return to the operating room; Kaplan-Meier analysis was used for statistical analysis. Results: A total of 13,161 patients with cleft lip or palate over the last 20 years underwent operative intervention (palatoplasty). Of those patients, ninety-seven patients were found to have diagnosis of post-operative bleeding (confidence interval 1.196 +/-0.606). One hundred and seventy-five patients experienced post operative hemorrhage requiring transfusion of blood product (CI 1.491 +/-0.952). Seventy patients required return to the operating room for post-operative bleeding in the immediate post operative period. Conclusions: Historic reporting of post-operative bleeding suggests a moderate rate of post-operative hemorrhage rate following palatoplasty, occasionally necessitating transfusion and return to operating room following index palatoplasty. Our retrospective review of a national database demonstrates a lesser incidence of post-operative hemorrhage than previously noted.