Craniosynostosis – Minimally Invasive Clinical Pathway

Pathway Background and Objectives

To date, all craniosynostosis patients have been admitted post operatively to the Pediatric Intensive Care Unit (PICU). Currently the majority of these children have minimally invasive craniosynostosis repair. With the minimally invasive surgery blood loss is minimal and there are fewer complications than with the open craniofacial surgeries. Currently these patients are discharged from the PICU on postoperative day 1, or they are transferred to the floor for a few hours and then discharged home. To improve quality of care and patient satisfaction these children can be directly admitted to the medical/surgical floors postoperatively if they meet certain criteria. This will have cost saving benefits as well as improved patient satisfaction for the families.

The specific objectives of this clinical pathway are to:

Improve and standardize care
Avoid unnecessary admission to the PICU
Reduce hospital length of stay
Improve patient and family satisfaction

Algorithm Educational Module

Key References

Allareddy V. Prevalence and impact of complications on hospitalization outcomes following surgical repair for craniosynostosis. J Oral Maxillofac Surg. 2014 Dec; 72(12):2522-30.
Arts S, Delye H, Van Lindert EJ, Blok L, Borstlap W, Driessen J. Intraoperative and postoperative complications in the surgical treatment of craniosynastosis: minimally invasive verses open surgical procedures. J Neurosurg Pediatr. 2018 Feb;21(2):112-118.
Burokas L. Craniosynastosis: Caring for infants and their families. Crit Care Nurse. 2013 Aug;33(4):39-50; quiz 51.
Han RH, Nguyen DC, Bruck BS, Skolnick GR, Yarbrough CK, Naidoo SD, Patel KB, Kane AA, Woo AS, Smyth MD. Characterization of complications associated with open and endoscopic craniosynostosis surgery at a single institution. J Neurosurg Pediatr. 2016 Mar;17(3):361-70.
Proctor MR. Endoscopic craniosynostosis repair. Transl Pediatr. 2014 Jul;3(3):247-58.

Disclaimer

The clinical pathways in the above links have been developed specifically for use at Connecticut Children’s and are made available publicly for informational and/or educational purposes only. The clinical pathways are not intended to be, nor are they, a substitute for individualized professional medical judgment, advice, diagnosis, or treatment. Although Connecticut Children’s makes all efforts to ensure the accuracy of the posted content, Connecticut Children’s makes no warranty of any kind as to the accuracy or completeness of the information or its fitness for use at any particular facility or in any individual case.