A healthy 3-month-old boy with an isolated complete unilateral cleft lip is scheduled for repair. His weight is 5.5 kg, haemoglobin is 11 g/dL, and he has had no recent infections. Which principle governs the timing of this operation?

• A Timing is arbitrary once anaesthesia facilities exist
• B Repair must wait until 12 months to allow maxillary growth completion
• C Repair is performed within the first 48 hours of life to aid maternal bonding
• D The rule of 10s: at least 10 weeks old, 10 pounds, 10 g/dL haemoglobin, 10,000 platelets ✓

Explanation

Traditional teaching for cleft lip repair is the rule of 10s: age over 10 weeks, weight over 10 pounds (about 4.5 kg), haemoglobin over 10 g/dL, and leucocytes and platelets near normal values. These criteria ensure the infant can safely tolerate anaesthesia and that the lip has grown enough for a durable repair. Cleft palate repair is timed separately, around 9 to 18 months, before speech development. Neonatal repair is generally avoided outside specialised protocols.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.