You'll find hundreds of files on cleft lip, cleft palate here on widesmiles.org.

This one is about: Bone Graft: Summary of Jacob's Experience


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Hi - - Joanne Green here. I have three kids with cleft - Jacob is 9 and had bone graft last July.

First, this surgery turned out NOT to be the horror I dreaded. In fact, compared with some of the others - almost a cake walk. Go to the gallery and check out Jacob's bone graft experience. I took a camera with me and uploaded 14 pictures of our adventure so that others facing that same surgery can "walk through" ours with us. (no graphic shots).

Basically, the surgery took 2 hours, he slept for 10 (Jacob always sleeps a long time after surgery) then he was eating as soon as he woke up (liquid and soft food diet) and was up and walking without a limp 12 hours after surgery. (the limp did come, but was never terrible.  More of a slow, careful walk beginning day 2 and lasting maybe 4 days.) The graft site was his hip. You can see in the photos how small the site was and he had only one stitch and a steri strip to hold it closed. About 1 inch long - 3 1/2 months later we can barely find the scar.

It hurt - all surgery does. Because it involves bone, it hurt more deeply and this is the first time any of my kids every used anything stronger than Tylenol. He used Tylenol w/ codeine for a couple of days. He was home 28 hours after surgery, climbing the stairs by himself to his room. Four days after surgery he was in church and by the following week he was in time-out for doing things like wrestling with his brother.

I did implement a very serious regimen that started weeks before the surgery, designed to ensure a successful graft (and at this point it looks really successful). There are 2 things that threaten the success of the bone graft. Those are blood flow, infection and trauma.

Blood flow - we couldn't do a lot about that. It's largely up to the doctor. But we did make sure he had plenty of liquids and a nutritious diet as the surgery approached.

Infection: Now here we could do a lot. We switched to an antiseptic mouthwash and antiseptic toothpaste weeks before the surgery so as to reduce bacteria in the mouth. He was scheduled for a hygienist cleaning just prior to surgery. After the surgery, he followed everything by mouth with clear water. He rinsed his mouth with warm salt water after every meal and twice per day he rinsed with antiseptic mouthwash.

Trauma: Jacob stayed on a liquid/soft food diet for two weeks. Then, even though the doctor cleared him for anything, I said no way - - no hard or crunchy foods for a full three months (it takes three months for the bone to grow). He was also not allowed to ride skates, skateboard or bicycle for three months, and he was not allowed to play ball games that could end up with a ball in the face, etc. We acted as though his face was made of glass.

Extra: Two other things played a part here too.  Jacob's surgery was done in the summer. I have heard that it is a clinical observation that bone grafts done in Spring or Summer months tend to be more successful than those done in Fall and Winter months. There is no statistical evidence for this - just observation.

Second, again, without empirical evidence to support my theory, it made sense to me that as long as we were harvesting and then growing bone, we should increase Jacob's calcium intake. We added at least one big glass of milk and a calcium supplement to his diet beginning 2 weeks before the surgery and through the following three months. Much of his liquid diet included homemade milkshakes, in which I included yogurt. Yogurt has a higher level of calcium than milk.

Hope this stuff helps. Be sure and check out Jacob's bone graft pix on the web. http://www.widesmiles2.org/gallery/green/jacob/jacobbg.htm


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