JANUARY 2020 • Volume 13, No. 1

From the Editor

January is National Birth Defects Prevention Month

We’re happy to publicize prevention tips, but since our audience is all about the OR, we also bring you some surgical news and resources about birth defects. For example, the photo at right shows a surgical team at the Cleveland Clinic hard at work on the clinic’s first in-utero spina bifida surgery. (See story under “News,” below.)

Birth defects are common, costly and critical. They range from very mild to life-threatening, and they can happen for many reasons. In many cases, the cause isn’t known. Risk varies by type of defect, family health history and the parents’ ages.

Not all birth defects can be prevented, but taking care to eat a healthy diet, including adequate folic acid, maintain a healthy body weight, and avoid alcohol, tobacco and drugs, can help increase a woman’s chances of having a healthy baby.

Here is a handy reference from the Centers for Disease Control and Prevention, listing the latest national statistics on the most common birth defects and their occurrence  in the United States.

Scroll down for our newest crossword puzzle, on the topic of procedure terminology, and to read about our Student in the Spotlight, Tiffany Williams, FPN, of Idaho Falls, ID.

You will also find the latest batch of job openings and NIFA’s favorite links.


Julie Lancaster, Editor


Spina Bifida

Spina bifida is a birth defect that occurs when a child’s neural tube does not fully close, affecting the lower spine. It can result in damage to the spinal cord and nerves, and even the brain.

Last February, doctors at the Cleveland Clinic conducted the clinic’s first in-utero surgery for this particular birth defect (see photo in previous section). Starting with a small, c-section-like incision, they used an ultrasound to locate the placenta and fetus, and made a small opening in the uterus to expose the fetus’ back. Then they sutured layers of tissue, repaired the defect, and closed the uterus, allowing the fetus to remain in the womb and continue developing for the duration of the pregnancy.

“The team prepared for this surgery for more than a year by visiting other centers, conducting simulations and consulting with other experts in the field,” the article states. “The procedure was pioneered by surgeons at the Children’s Hospital of Philadelphia.”  Read more . . .

Cleft Lip and Palate 

Between the fourth and eight weeks of pregnancy, the lip and palate are formed. A cleft occurs when the fusion of the lip or palate is incomplete. Read this journal article about which techniques of cleft lip repair surgery have been found to produce the most aesthetically pleasing results.

Anotia or Microtia

Anotia and microtia are birth defects of a baby’s ear. In anotia, the external ear is missing completely; in microtia, the external ear is small and not formed properly. Reconstructing the ears of microtia patients has long been a goal in tissue engineering. Marking a milestone in the field, scientists in China have recently grown and reconstructed new ears for five children born with microtia. Read more . . .


Cleft Lip and Palate – Pediatric Otolaryngologist Shelagh Cofer, MD, of the Mayo Clinic Children’s Center presents: “Cleft Lip and Palate: State of the Art and Science.” She discusses different cleft lip and palate disorders, goals for reconstruction, prenatal diagnosis,  presurgical infant orthopaedics, dynacleft tape, scar contracture and more. Watch video . . .

Ear Reconstruction Surgery – An alternative technique for ear reconstruction uses a pre-fabricated, artificial porous polyethylene framework to create the ear shape. This framework is then covered by a flap of tissue (fascia) from the side of the head that lies just below the scalp, and a skin graft.  Watch video . . .

Crossword Puzzle: Procedure Terminology

Test your knowledge of procedure teminology with this month’s all-new crossword puzzle.

When you’re ready to check your answers, follow this link to see how well you did. Good luck!


Student Spotlight: Tiffany Williams

Credentials:   FNP

Student Status:   Current Student

City & State:   Idaho Falls, ID

Current Position:   Family Nurse Practitioner

Where did you get your RN degree?  Idaho State University in Idaho Falls and Gonzaga University in Spokane, WA.

How did you come to choose perioperative nursing? 
Moving forward as a new NP, I wanted to work with our surgeons and I have enjoyed PACU and trauma.

What is the scariest moment you’ve ever seen at the table?  
Limited experience. I did watch an MD crack a chest in CT, when I was a new nurse 18 years ago.

What is one technique or RNFA trick you’ve learned from NIFA that you will use for life?  Dean’s zest for learning and his level of professionalism and desire to do a job and do it right. He clearly puts in all the effort to be an expert in his area.

How do you feel having your RNFA will impact your life/career? 
More opportunities for learning and paying it forward.

Photo: Tiffany with “newborn” at the recent Dallas SutureStar workshop. 

Jobs Front

Click here for the RNFA job postings we’ve collected for you this month.

NIFA – Office Hours

Monday-Thursday, 8:00am – 4:00pm
Friday, 8:00am – 3:00pm

Practice Resources

Here are several of the most-in-demand sites for our students, prospective students and grads:

MD Edge Surgery News: Specialty News and Commentaries, Videos and More
RNFA Scope of Practice by State (PDF)
ACS List of Cases that Require an Assistant at Surgery, 2018 (PDF)
Perioperative Nurse Links (state nursing boards & professional associations)
APRN Nurse Links

Disclaimer: The views expressed in this newsletter are strictly those of their respective authors and do not necessarily represent the views of NIFA. NIFA does not give any express or implied warranty as to the accuracy of statements made by our contributors and does not accept any liability for error or omission. It is the responsibility of all perioperative personnel to work within and adhere to their facility bylaws and individual scope of practice.

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