Abstract
Objective: To qualitatively assess surgeons’ decision making for lip surgery in patients with cleft lip/palate (CL/P).
Design: Prospective, non-randomized, clinical trial.
Setting: Clinical data institutional laboratory setting.
Patients, Participants: The study included both patient and surgeon participants recruited from four craniofacial
centers. The patient participants were babies with a CL/P requiring primary lip repair surgery (n=16) and adolescents
with repaired CL/P who may require secondary lip revision surgery (n=32). The surgeon participants (n=8) were
experienced in cleft care. Facial imaging data that included 2D images, 3D images, videos, and objective 3D visual
modelling of facial movements were collected from each patient, and compiled as a collage termed the ‘Standardized
Assessment for Facial Surgery (SAFS)’ for systematic viewing by the surgeons.
Interventions: The SAFS served as the intervention. Each surgeon viewed the SAFS for six distinct patients (two
babies and four adolescents) and provided a list of surgical problems and goals. Then an in-depth-interview (IDI) was conducted with each surgeon to explore their decision-making processes. IDIs were conducted either ‘in person’ or
virtually, recorded, and then transcribed for qualitative statistical analyses using the Grounded Theory Method.
Results: Rich narratives/themes emerged that included timing of the surgery; risks/limitations and benefits of surgery;
patient/family goals; planning for muscle repair and scarring; multiplicity of surgeries and their impact; and availability
of resources. In general, there was surgeon agreement for the diagnoses/treatments.
Conclusions: The themes provided important information to populate a checklist of considerations to serve as a guide
for clinicians.
Keywords: cleft lip/palate; decision-making; clinical trial; lip repair; lip revision; qualitativ
Design: Prospective, non-randomized, clinical trial.
Setting: Clinical data institutional laboratory setting.
Patients, Participants: The study included both patient and surgeon participants recruited from four craniofacial
centers. The patient participants were babies with a CL/P requiring primary lip repair surgery (n=16) and adolescents
with repaired CL/P who may require secondary lip revision surgery (n=32). The surgeon participants (n=8) were
experienced in cleft care. Facial imaging data that included 2D images, 3D images, videos, and objective 3D visual
modelling of facial movements were collected from each patient, and compiled as a collage termed the ‘Standardized
Assessment for Facial Surgery (SAFS)’ for systematic viewing by the surgeons.
Interventions: The SAFS served as the intervention. Each surgeon viewed the SAFS for six distinct patients (two
babies and four adolescents) and provided a list of surgical problems and goals. Then an in-depth-interview (IDI) was conducted with each surgeon to explore their decision-making processes. IDIs were conducted either ‘in person’ or
virtually, recorded, and then transcribed for qualitative statistical analyses using the Grounded Theory Method.
Results: Rich narratives/themes emerged that included timing of the surgery; risks/limitations and benefits of surgery;
patient/family goals; planning for muscle repair and scarring; multiplicity of surgeries and their impact; and availability
of resources. In general, there was surgeon agreement for the diagnoses/treatments.
Conclusions: The themes provided important information to populate a checklist of considerations to serve as a guide
for clinicians.
Keywords: cleft lip/palate; decision-making; clinical trial; lip repair; lip revision; qualitativ
Original language | English |
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Pages (from-to) | 1-16 |
Number of pages | 16 |
Journal | Journal of Dermatology and Dermatitis |
Volume | 8 |
Issue number | 5 |
Early online date | 27 Oct 2023 |
DOIs | |
Publication status | Published - 27 Oct 2023 |