I cannot tell if the wound is healing correctly without seeing your child, so please call me or bring them in today if you have any concerns or notice increased redness and swelling.
I understand you are concerned about whether the wound is okay. I would like to arrange a teleconsultation so the surgeon can look at your child via video. Please reply to this message or call the office and I will find a time for you.
TIER: amber
ITEMS_WORSENING: Feeding, Pain behaviour, Sleep, Fever
TREND_TWO_DAY: no
PHOTO_AGREEMENT: no photo
ESCALATION_DRAFTED: Same-day surgeon review triggered due to multiple worsening symptoms (feeding, pain, sleep, low-grade fever).
Dear Mother,
Thank you for providing the daily update. Regarding your question about whether the wound is okay, we cannot confirm this today because the photo provided was unusable (blurry or poor lighting). We need a clear, high-resolution photo in bright light to properly check the wound.
Looking at your report, there are several areas of concern. The child’s feeding is slightly reduced, and breastfeeding specifically has reduced. The child is also irritable, sleeping poorly, and feels warm to the touch. While the swelling and redness remain the same as at discharge, the presence of blood-stained saliva combined with these other changes is not part of a routine recovery.
Because of the reduction in feeding, the irritability, and the low-grade fever, your child requires a review today. According to our protocol, we do not wait for the Tuesday clinic when these symptoms appear. The surgical team will call you today to arrange an immediate review.
Practical Recommendations:
- Medication: Give the prescribed take-home medicines—syrup or tablets paracetamol (or ibuprofen)—exactly as ordered. Do not stop them early or add any other medicine. If an antibiotic was prescribed, complete the full course exactly as ordered; only the managing consultant can change this regimen.
- Feeding: Continue cup, spoon, or syringe feeds as instructed. Strictly avoid bottle teats, pacifiers, or thumb-sucking.
- Wound Care: Keep the wound clean as instructed at discharge. Keep the elbow restraints („no-nos“) on except during supervised play to prevent the child from touching the lip.
- Photos: Please send a clear, high-resolution photo today. Ensure the light is bright, the camera is parallel to the lip, and the distance is the same as the first photo taken at the clinic.
- Clinic: Your regular weekly follow-up remains at the Cleft Clinic (Tuesdays, 12 noon, 2nd Floor, Outpatient Clinic), where we will monitor weight and growth.
Safety Net: Contact the clinic immediately if pain or swelling increases on two consecutive days, or if you notice active bleeding, pus, a fever of 38.5 °C or higher, the wound opening, or any difficulty breathing.
Dr. Adegbayi Adeola ADEKUNLE BChD, MSc, FAOCMF, FMCDS, FWACS
Surgeon / Lecturer, Oral and Maxillofacial Surgery
Lagos University Teaching Hospital / College of Medicine, University of Lagos
+234 803 561 8530
(with AI support, not signed)
Termin vereinbaren
Ordination Dr. Michael Truppe
Albertgasse 3/6 1080 Wien
Telefon 01 408 95 00 66
Email ordination@smile.wien
Ein verbindlicher Behandlungsplan und Heilkostenplan wird gemäß den Vorgaben der Zahnärztekammer erst nach einer Konsultation in der Praxis erstellt.
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