New program to make surgery safer for children with cleft

What is Clean Cut for Cleft and how will it make surgery for children with cleft safer?

Clean Cut for Cleft is a new program – launched today by Smile Train and Lifebox – to tackle one of the greatest risks to surgical patients: infection. 

"Patients in low-income countries suffer disproportionately from surgical infections. Clean Cut for Cleft is a locally-led and affordable way for surgical teams to make surgery safer for every child with a cleft and give them the future that they deserve.”
Dr. Tihitena Negussie, pediatric surgeon, Tikur Anbessa Hospital, Lifebox Global Clinical Director, and principal lead of the Clean Cut for Cleft research project.

Surgical site infections are the leading hospital acquired infection in low- and middle-income countries – where rates of infection are more than double that of the United States1. Children with cleft face greater risks from surgery than other patients. 

Clean Cut for Cleft, which is part of the Smile Train-Lifebox Safe Surgery and Anesthesia Initiative, focuses on achieving safer surgery for children with cleft lip and palate. The program aims to reduce surgical site infections as well as the main complications faced by cleft patients undergoing surgery, such as airway compromise or delayed bleeding. The program is launching at the Smile Train partner hospitals of Yekatit 12 and the African Leprosy Research (ALERT) Hospital in Ethiopia’s capital, Addis Ababa.

Surgical team at Yekatit 12 Hospital, a Clean Cut for Cleft pilot site and Smile Train partner hosptial

“Clean Cut for Cleft  is a vital  program for cleft patients and will bring about major change in preventing infections and reducing morbidity and mortality related to surgeries,”
Dr. Getaw Alamnie, plastic and reconstructive surgeon, African Leprosy Research (ALERT) Hospital, Ethiopia, and Clean Cut for Cleft Fellow.

Clean Cut for Cleft is an adaptation of the Lifebox Clean Cut program which tackles the risk of infection by strengthening six key infection prevention practices, such as the sterility of surgical instruments and antibiotic administration. 

The results of Clean Cut have been published in the British Journal of Surgery – showing a 35% reduction in infection in all surgical patients2. The lasting impact of Clean Cut was published in The Journal of the American Medical Association (JAMA) Surgery showing hospitals maintained improvements in compliance with all six program infection prevention standards – demonstrating the program’s impact and sustainability3. Most importantly, for scalability across low- and middle-income countries, Clean Cut requires no major investments in new infrastructure or resources. To date, Clean Cut has been implemented in 14 hospitals in three countries, impacting over 100,000 surgical patients. 

Clean Cut for Cleft is a research project that will gather data to measure the impact of the program on the safety of cleft patients. The goal is to pilot a program that can be replicated in other hospitals and contexts so that all children born with cleft can access safe and effective surgery.

"A child born in a low-resource setting is twice as likely to get an infection following surgery than one born in the United States. I am proud to see Smile Train and Lifebox innovating to improve surgical safety for our children with Clean Cut for Cleft.” Professor Miliard Derbew, pediatric surgeon and CEO King Faisal Hospital, Rwanda, Global Ambassador of the Smile Train-Lifebox Safe Surgery and Anesthesia Initiative

Smile Train and Lifebox will launch Clean Cut for Cleft at a Smile Train partner hospital in Cote d’Ivoire in the coming months. Find out more about the work of the Smile Train-Lifebox Safe Surgery and Anesthesia Initiative.