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. 2024 Feb 8;16(2):e53832. doi: 10.7759/cureus.53832

Table 1. Questionnaire on the rule of 10.

QUESTION NO. QUESTIONS ANSWERS
1 What is the average blood loss in unilateral cleft lip repair in patients aged between 6 months to 1 year (personal experience)? (a) 10-20 mL, (b) 20-40 mL (c), 40-60 mL, (d) Above 60 mL
2 What is the average blood loss in bilateral cleft lip repair in patients aged between 6 months to 1 year (as per personal experience)? (a) 10-20 mL, (b) 20-40 mL, (c) 40-60 mL, (d) Above 60 mL
3 What is the average hemoglobin level of patients reporting cleft lip to your centers for the repair of cleft lip? (a) Less than 8 gm/dL, (b) 8-9 gm/dL, (c) 9-11 gm/dL, (d) Above 12 mg/dL
4 Have you ever been required to transfuse blood post-cleft lip repair? (a) Yes, (b) No
5 Do you apply the ‘Rule of 10’ as a standard for case selection in cleft lip repair? (a) Yes, (b) No
6 Does delay in the surgery of cleft lip impact the long-term outcomes of cleft lip repair? (a) Yes, (b) No
7 What is the minimum Hb% and weight of the child at your centres for unilateral cleft lip repair? Answer
8 What is the minimum Hb% and weight of the child at your centres for bilateral cleft lip repair? Answer
9 How do you proceed with patients presenting with cleft lip with pre-operative lower levels of haemoglobin between 8-10 gm%? (a) Delay in surgery with nutritional supplements, (b) Proceed with surgery with nutritional supplements, (c) Proceed with the procedure with blood loss-reducing agents (haemostatic agents), (d) Others
10 What complications have you recorded when operating on a child with less than 9 gm% of Hb (surgical and aesthetic)? a) Increased bleeding, b) Poor healing, c) Intraoperative desaturation, d) None
11 What all preoperative and intraoperative anaesthetic measures are taken in your centres to reduce bleeding in patients with haemoglobin between 8 and 10 gm%? a) Judicious use of cautery, b) Systemic tranexamic agents, c) Mechanical pressure, d) Nothing specific
12 Age at which repair of cleft lip is undertaken at your centre. a) < 3 months, b) 3-6 months, c) More than 6 months
13 Your comments on the “Rule of 10” for cleft lip repair. a) Gold standard, b) Not relevant in the current era, c) Not a standard that always needs to be adhered to