Paganini Anna, Hörfelt Camilla, Mark Hans
a Department of Plastic Surgery, Institute for Clinical Sciences, Sahlgrenska Academy , Göteborg University, Sahlgrenska University Hospital , Göteborg , Sweden.
J Plast Surg Hand Surg. 2018 Apr;52(2):106-110. doi: 10.1080/2000656X.2017.1348951. Epub 2017 Jul 14.
Numerous gender-based differences in medical treatment have been recognized due to conscious or unconscious perceptions, i.e. gender bias. The aim of the present study was to investigate whether gender differences exist in the surgical treatment of patients with cleft lip and palate (CLP) anomalies. This study is a retrospective review of 235 consecutive patients with non-syndromic unilateral CLP or bilateral CLP born between 1966 and 1986. Each chart was reviewed, and 2178 surgical procedures were registered and categorized as primary surgery (primary lip, palatal and alveolar repair) or secondary surgery (aesthetic and functional revision). Different surgical procedures could be performed during the same surgical session. The number of surgeries performed was analysed and compared between genders. The results demonstrate that women with CLP received statistically significantly more secondary surgeries than men. No differences in the number of primary surgeries were identified. This study provides a gender perspective of the treatment of CLP. We identified no gender differences in primary surgery of the CLP. The standardized method of repairing the cleft is effective in preventing unjust treatment due to gender. However, we identified an indication of gender bias in cleft care regarding secondary surgeries of the nose and lip, namely, women are over-treated and/or men are under-treated. There are several possible explanations for this phenomenon, and further studies are needed.
由于有意识或无意识的认知，即性别偏见，人们已经认识到在医疗治疗中存在许多基于性别的差异。本研究的目的是调查唇腭裂（CLP）异常患者的手术治疗中是否存在性别差异。本研究是对1966年至1986年间出生的235例连续性非综合征性单侧唇裂或双侧唇裂患者的回顾性研究。对每份病历进行了审查，记录了2178例手术，并将其分类为初次手术（初次唇、腭和牙槽修复）或二次手术（美学和功能修复）。在同一次手术过程中可以进行不同的手术操作。分析并比较了不同性别患者的手术次数。结果表明，唇腭裂女性接受的二次手术在统计学上显著多于男性。未发现初次手术次数存在差异。本研究提供了唇腭裂治疗的性别视角。我们发现在唇腭裂的初次手术中不存在性别差异。标准化的腭裂修复方法有效地防止了因性别导致的不公平治疗。然而，我们发现在唇腭裂护理中，关于鼻唇二次手术存在性别偏见的迹象，即女性接受了过度治疗和/或男性接受了不足治疗。对于这一现象有几种可能的解释，需要进一步研究。
