Edwar Alvarez Md, Usman Khalid Farooq, David Alvarez Md, Andrea Iñiguez Md, Ghulam Qadir Fayyaz.
THE RED CODE. a New Concept in the Prevention of Post-Surgery Bleeding of the Cleft patient. a Multicentric Study.
Pak J Plastic Surg Jan ;08(2):57-63.

Introduction: Bleeding, during post-operative period is not only frustrating for the surgeon but may also lead to life threatening condition for the patient. Sometimes if uncontrolled or not managed adequately can lead to death of patient. It's a worldwide problem as evident with articles from all over the world, especially dangerous in pediatric patients and more specifically cleft surgery patient post operatively. Objective: The objective of the study was to determine an algorithm which can help in the management and prevention of postoperative bleeding cleft patients. Methods: This paper presents the Red Code Algorithm, for pre, intra and postoperative management of cleft patients. The study was performed in different centers of Smile Train Foundation in Ecuador, Peru, Paraguay, Nicaragua and Morocco. Results: We studied 864 primary and secondary cleft lip and palate surgeries, performed during one year by the same group of surgeons. In these 864 consecutive cases the Red Code Algorithm was applied. Forty-five patients (5.3%) presented more bleeding compared to the average of patients, and 2 cases (0.23%) required surgical re-intervention for hemostasis control. The control group had a total of 1243 patients, who had surgery by the same team before the introduction of the Red Code Algorithm. Of them, 113 cases (9.1%) presented more bleeding compared to the average, and 37 cases (2.97%) required surgical re-intervention to achieve hemostasis control. Conclusion: This approach reduced the incidence of postoperative bleeding in all types of cleft surgeries. Keywords | Red Code, Bleeding, Cleft surgery Received | 08-08-2020: Accepted | 02-10-2020

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