Plastic Surgery Outcomes

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Why Choose Us: Plastic Surgery

Our Outcomes: The Results of Our Care

Nemours pediatric plastic surgeons help children of all ages with birth defects, injuries, tumors and other conditions feel better, inside and out. We’re committed to performing the most effective and least invasive procedures with the fewest trips to the operating room. If your child needs any kind of procedure performed by Nemours plastic surgeons, know that you’re getting top-notch surgical care from some of the best pediatric surgical specialists in the field. In fact, at Nemours, we’re a national leader in surgical results and overall quality of surgical care.

Why Measuring Results Matters

To provide pediatric care that's among the safest and most effective for all children, we measure our results and compare them to national pediatric rates. We're also conducting research in the outcomes of surgical procedures. Why? So we can:

  • help you make decisions about your child’s care
  • be clear about our results
  • improve so we can consistently deliver better, safer care

Here are a few outcomes we track and focus on to improve the experience for both you and your child.

 

Preventing Wound Infections

Preventing Wound Infections


Making Sure Kids Don’t Get Wound Infections After Surgery

When your child needs surgery, you probably aren’t thinking about infections in surgical wounds (where the surgeon cut into the skin). You’re likely just focusing on the operation itself and hoping it helps correct your child’s condition. But, just like when your child gets an everyday cut or scrape, preventing infections in surgical wounds is important. When it comes to an operation, preventing wound infections is essential because it means a faster recovery and a shorter hospital stay. That’s why we track our “post-operative wound infection rate” (that’s the number of infections after surgery).

To help keep children from having complications like infections after their operation, we:

  • Encourage all of our patients' families to sign up and use MyNemours. The parent portal of our award-winning electronic health record system gives you secure access to your child’s records and allows you to communicate by email with your provider(s). So families can immediately report a problem and make sure it gets noticed and noted in the system so someone can contact you right away.
  • Make a follow-up call within 24 hours after surgery to make sure everything is okay. We ask questions about how your child's feeling and how the surgical wound looks (and is healing) so that we can address any concerns as soon as possible.
  • Give antibiotics and use other state-of-the-art infection prevention techniques before, during and/or after an operation as needed. This helps curb infections during and after the procedure.
  • Review and discuss unusual infections and complications after surgery with every member of the division. We want to find out what happened and what, if anything, we could do to prevent a complication in the future.

 

Post-Operative (After Surgery) Wound Infections

0%

Wound infections

Data source: Data collected for Nemours/Alfred I. duPont Hospital for Children (Wilmington, Del.) from the National Surgical Quality Improvement Program-Pediatric (ACS NSQIP Pediatric), Semiannual Report, July 1, 2016-June 30, 2017. A partnership of the American College of Surgeons and the American Pediatric Surgical Association, ACS NSQIP Pediatric has more than 100 children's surgical program participants across the country. Currently at Nemours, only duPont Hospital for Children is part of NSQIP and, when compared in the ACS NSQIP Pediatric system, performs overall as expected for children’s surgical programs.

Keeping Kids From Having to Stay at the Hospital

Keeping Kids From Having to Stay at the Hospital


Preventing Hospital Admissions After Surgery

Sometimes kids with chronic or complex conditions have planned repeat hospitalizations for ongoing medical care. Sometimes children are admitted with new infections, respiratory problems, gastrointestinal illnesses, etc. However, it’s important to avoid as much as possible, potentially preventable admissions — such as hospital-acquired infections (when a patient gets an infection during surgery or hospital stay) or returns to the hospital (readmissions) because a problem wasn’t properly recognized or treatment was incomplete. It’s important to minimize unplanned admissions (and readmissions) because they can:

  • interfere with your child’s and family’s life — cause missed school, work and important events (e.g., sports, vacations)
  • be costly to you, the parents, especially if you have co-pays or high deductible insurance

At Nemours, we want to make sure kids don't have to be admitted to the hospital after surgery by:

  • scheduling follow-up appointments and tests after surgery
  • providing clear educational materials and discharge instructions to families, including correct medications and doses
  • giving families access to a Nemours physician for postdischarge questions through our CareConnect telehealth service
  • encouraging online communication through your child’s electronic health record — MyNemours for families

 

Unplanned Hospital Admissions for a Plastic Surgery Issue Within 30 Days of Original Operation

0%

Unplanned readmissions

Data source: Data collected for Nemours/Alfred I. duPont Hospital for Children (Wilmington, Del.) from the National Surgical Quality Improvement Program-Pediatric (ACS NSQIP Pediatric), Semiannual Report, July 1, 2016-June 30, 2017. A partnership of the American College of Surgeons and the American Pediatric Surgical Association, ACS NSQIP Pediatric has more than 100 children's surgical program participants across the country. Currently at Nemours, only duPont Hospital for Children is part of NSQIP and, when compared in the ACS NSQIP Pediatric system, performs overall as expected for children’s surgical programs.

Preventing Complications After Cleft Palate Surgery

Preventing Complications After Cleft Palate Surgery


Reducing Fistulas From Palate Repair

Cleft lip (an opening in the lip) and cleft palate (an opening in the roof of the mouth) are among the most common major birth defects (also called "anomalies"). About one or two of every 1,000 babies born in the United States each year have a cleft lip or cleft palate. Most children can have surgery to repair cleft issues within the first 12-18 months of life.

When a palate is repaired, tissue from each side of the palate is stitched together, creating a seam. The repaired palate separates the space in the mouth from the inside of the nose. If part of the seam doesn’t heal well and opens up, a pathway from the mouth into the nose can return. This opening (called a “fistula”) may allow food or drink to enter the nose, or mucous from the nose to enter the mouth. If enough air escapes from the mouth into the nose, it may have an effect on speech too. At Nemours/Alfred I. duPont Hospital for Children, we strive to prevent fistulas and other complications — and to promptly address them if they do occur.

 

Fistula Rate After Cleft Palate Surgery

1.9%

Nemours cleft palate patients with a fistula

4.9%

National average (benchmark)

Data sources: Nemours data collected from electronic health records of plastic surgery patients at Nemours/Alfred I. duPont Hospital for Children (Wilmington, Del.); Nemours duPont Pediatrics, Bryn Mawr (Bryn Mawr, Pa.); and Nemours duPont Pediatrics, Deptford (Deptford, N.J.); Jan. 7, 2015-Nov. 28, 2017.
Benchmark: Findings from recent article (2014) performing meta-analysis of data from articles published over at least 10 years shows a national average of 4.9 percent. Bykowski MR, Naran S, Winger DG, Losee JE. The rate of oronasal fistula following primary cleft palate surgery: a meta-analysis. Cleft Palate-Craniofacial Journal 2014: epub. [PubMed: 25322441]

Our Differentiators: What Sets Us Apart

Our Differentiators: What Sets Us Apart


Why Choose Nemours Plastic Surgery

Plastic surgery in children is much different than in adults. Not only are their bodies still growing and changing, but kids have different social and emotional challenges that only a pediatric team can fully address. Here are just some of the reasons families choose Nemours for their children’s plastic surgery care:

  • Experienced, highly skilled plastic surgeons. Our pediatric plastic surgeons are board-certified and fellowship-trained to provide the highest level of surgical and medical care for simple to complex conditions. We’re technically meticulous in our techniques, which contributes to our low complication rate.
  • World-class surgeons with the highest level of expertise. Our division includes plastic surgeons who have extensive experience and/or subspecialty training in a variety of pediatric conditions.
  • Collaborative, team approach to your child’s care. Our surgeons work closely with multispecialty teams built around your child’s condition, including neonatologists, otolaryngologists (ear, nose and throat, or ENT doctors), geneticists, speech-language therapists and anyone else your child needs to see.
  • Close, personalized care for families. We treat every child as our own, and include you in every decision because we recognize that you know your child best. We work together to tend to your child’s physical, emotional and social needs before and after surgery.