除了听健康新生儿的哭声,分娩室的主治儿科医生宣布孩子是正常的,这给父母带来了最大的快乐。据报道,全球先天畸形儿童的发病率为3%-6%,其中90%以上发生在低收入和中等收入国家。由于多种原因,无法估计需要手术治疗的儿童的确切百分比/总数。这些孩子在几个外科学科下手术,即,pediatrc-,塑料重建,神经-,心胸-,整形外科等.这些情况可能会危及生命,例如,气管-食管瘘,临界肺动脉狭窄,等。需要立即手术干预.一些,例如,脑积水,一旦患者适合手术,可能需要干预。一些,例如,动脉导管未闭需要“等待观察”政策直到一定年龄才能自发恢复。另一个非常重要的类别是根据年龄进行手术干预的患者。几乎所有由整形外科医生护理的先天性异常都在适当的年龄作为选择性手术(许多是矫正的多个阶段)进行手术。不同年龄段的干预措施各有优缺点。在这篇文章中,我们对最佳时机进行了回顾,随着推理,用于整形外科医生治疗的许多常见先天性畸形的手术。产科医生,儿科医生和全科医生/家庭医生,他们通常是第一个遇到这种孩子的人,必须知道适当地引导父母,令人信服地打动他们,为什么他们的孩子不应该立即进行手术,以及过早或过晚的后果。
Apart from listening to the cry of a healthy newborn, it is the declaration by the attending paediatrician in the labour room that the child is normal which brings utmost joy to parents. The global incidence of children born with congenital anomalies has been reported to be 3%-6% with more than 90% of these occurring in low- and middle-income group countries. The exact percentages/total numbers of children requiring surgical treatment cannot be estimated for several reasons. These children are operated under several surgical disciplines, viz, paediatric-, plastic reconstructive, neuro-, cardiothoracic-, orthopaedic surgery etc. These conditions may be life-threatening, e.g., trachea-oesophageal fistula, critical pulmonary stenosis, etc. and require immediate surgical intervention. Some, e.g., hydrocephalus, may need intervention as soon as the patient is fit for surgery. Some, e.g., patent ductus arteriosus need \'wait and watch\' policy up to a certain age in the hope of spontaneous recovery. Another extremely important category is that of patients where the operative intervention is done based on their age. Almost all the congenital anomalies coming under care of a plastic surgeon are operated as elective surgery (many as multiple stages of correction) at appropriate ages. There are advantages and disadvantages of intervention at different ages. In this article, we present a review of optimal timings, along with reasoning, for surgery of many of the common congenital anomalies which are treated by plastic surgeons. Obstetricians, paediatricians and general practitioners/family physicians, who most often are the first ones to come across such children, must know to guide the parents appropriately and convincingly impress upon the them as to why their child should not be operated immediately and also the consequences of too soon or too late.