Can Alveolar Bone Grafting Using Posterior Iliac Crest be a Day Surgery Procedure?

OBJECTIVE: The purpose of this study was to determine if patients undergoing alveolar bone grafting (ABG) can be discharged home on the day of surgery safely and with high satisfaction.

DESIGN: This is a prospective cohort study of patients who underwent ABG over a 6-month period (August 2022 to February 2023). Medical records were reviewed, and postoperative surveys were provided to assess patient/family experience.

SETTING: Tertiary care free-standing pediatric hospital.

PATIENTS AND PARTICIPANTS: Participants who had ABG using iliac marrow from the posterior iliac crest.

INTERVENTIONS: Subjects were assigned to overnight admission (ON) or day surgery (DS) based on hospital bed capacity.

MAIN OUTCOME MEASURES: Main outcome measures were postoperative medical events and satisfaction with discharge timing.

RESULTS: 41 participants were included: ON, n = 20 (48.8%); DS, n = 21 (51.2%), and there were no differences between groups in any predictor variable. There were no postoperative medical events. Overall, families reported comfort managing pain, nausea, bleeding, hydration, and nutrition after discharge. Most (83.3% of the DS group and 69.2% of the ON group, P  = .644) reported satisfaction with the discharge timing they received, despite this being driven by hospital rather than patient factors. Reasons for some families preferring longer admission included fluid management (n = 2), anxiety about postoperative swelling (n = 2), and a long drive home (n = 1). For the ON group, 16.7% would have preferred same-day discharge.

CONCLUSIONS: Same day discharge is safe and well-received in appropriately selected patients who undergo ABG using posterior iliac crest. Perioperative patient/family education is essential.