{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T10:55:44Z","timestamp":1794308144650,"version":"4.9.0"},"reference-count":28,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T00:00:00Z","timestamp":1752710400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe and demonstrate the effectiveness and reproducibility of a modified enhanced recovery after surgery (ERAS) protocol for patients with cleft palate (CP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Outreach Medical Programs, resource-limited settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients<\/jats:title>\n                    <jats:p>\n                      Pediatric patients with CP who underwent CP repair\n                      <jats:italic toggle=\"yes\">.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Modified ERAS protocol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s)<\/jats:title>\n                    <jats:p>\n                      Complication rate, post-operative pain management, time to discharge\n                      <jats:italic toggle=\"yes\">.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>52 CP repairs done during three outreach medical programs were included in the study. 22 (42.3%) procedures were performed in GYE SEP 2022, 6 (11.5%) procedures in SAL JAN 2023, and 24 (46.2%) in GYE MAR 2023. The mean age was 4.9 years across all programs. 22 (42.4%) patients were between 1 and 3 years of age, 26 (50%) were between 3 and 12 years of age, and 4 (7.6%) were older than 12 years of age. Patients were equally distributed among gender with 26 (50%) being males and 26 (50%) females. A total complication rate of 5.8% was reported. 51 patients were discharged on post-op day one and only one patient was kept for an additional day for monitoring. Four patients required Fentanyl in PACU for post-operative pain, ketamine was used in 1 patient, 7 patients received Dexmedetomidine (Precedex), and ketorolac was used in 16 patients<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A modified ERAS protocol for CP surgery has been developed and implemented for outreach settings. This approach showed decreased post-operative complications, decreased length of hospital stay, and decreased opioid use while maintaining adequate pain control, establishing early enteral feeding and thus enhancing patient recovery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656251357374","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T08:04:11Z","timestamp":1752739451000},"page":"2017-2026","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Enhanced Recovery After Cleft Palate Surgery: Protocol Development and Implementation in Outreach Settings"],"prefix":"10.1177","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9467-2531","authenticated-orcid":false,"given":"Roland K","family":"Assaf","sequence":"first","affiliation":[{"name":"Global Smile Foundation, Norwood, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4236-8589","authenticated-orcid":false,"given":"Robert","family":"Younan","sequence":"additional","affiliation":[{"name":"Global Smile Foundation, Norwood, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Haddad","sequence":"additional","affiliation":[{"name":"Global Smile Foundation, Norwood, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3529-6249","authenticated-orcid":false,"given":"Wassim","family":"Najjar","sequence":"additional","affiliation":[{"name":"Global Smile Foundation, Norwood, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8818-6978","authenticated-orcid":false,"given":"Antonio","family":"Melhem","sequence":"additional","affiliation":[{"name":"Global Smile Foundation, Norwood, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4140-201X","authenticated-orcid":false,"given":"Elsa","family":"Chahine","sequence":"additional","affiliation":[{"name":"Global Smile Foundation, Norwood, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0626-720X","authenticated-orcid":false,"given":"Dana","family":"Andari","sequence":"additional","affiliation":[{"name":"Global Smile Foundation, Norwood, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2245-2054","authenticated-orcid":false,"given":"Rami S","family":"Kantar","sequence":"additional","affiliation":[{"name":"Hansj\u00f6rg Wyss Department of Plastic Surgery, New York University Langone Health, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5442-0786","authenticated-orcid":false,"given":"Raj","family":"Vyas","sequence":"additional","affiliation":[{"name":"University of California Irvine School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3654-7262","authenticated-orcid":false,"given":"Usama S","family":"Hamdan","sequence":"additional","affiliation":[{"name":"Global Smile Foundation, Norwood, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,17]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Global registry and database on craniofacial anomalies: report of a WHO Registry Meeting on Craniofacial Anomalies. 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