Should surgeons use arm restraints after cleft surgery?

Background: Most cleft surgeons require children to wear postoperative arm restraints although the literature suggests that there is no difference in early complications. The aim of this study was to determine if the use of postoperative arm restraints was effective in preventing early postoperative complications.
Methods: We reviewed 120 consecutive primary cleft surgeries in which 1 surgeon used arm restraints in all patients and the other surgeon did not. Demographic information was obtained and complications were reviewed. We compared infection, fistula, and dehiscence between the 2 groups.
Results: In 120 primary cleft surgeries, there was no difference in early complications in patients who were required to wear arm restraints versus those who were not (P<0.05).
Discussion: Arm restraints are unnecessary and may cause distress in both patients and their families. Eliminating arm restraints from cleft care would save the health care system an estimated $234,000 annually.