Vascularized tissue transfer in head and neck surgery: Is intensive care unit-based management necessary?

Laryngoscope

Volumn 126, Issue 1, 2016, Pages 73-79

  Panwar, Aru ^a,b   Smith, Russell ^a,b   Lydiatt, Daniel ^a,b   Lindau, Robert ^a,b   Wieland, Aaron ^a,b   Richards, Alan ^a,b   Shostrom, Valerie ^c   Militsakh, Oleg ^a,b   Lydiatt, William ^a,b  

^a NEBRASKA MEDICAL CENTER   (United States)

^b Nebraska Methodist Women's Hospital   (United States)

^c UNIVERSITY OF NEBRASKA LINCOLN   (United States)

Author keywords

cost; free flap; Head and neck; intensive care unit; length of stay; microvascular reconstruction; outcomes; postoperative care; vascularized tissue transfer

Indexed keywords

ADULT; ALCOHOL ABUSE; ASSISTED VENTILATION; BODY MASS; CARDIOVASCULAR DISEASE; CLINICAL PROTOCOL; COHORT ANALYSIS; COMPARATIVE STUDY; CONFERENCE PAPER; CONTROLLED STUDY; FEMALE; FREE TISSUE GRAFT; GRAFT FAILURE; GRAFT SURVIVAL; HEAD AND NECK DISEASE; HEAD AND NECK SURGERY; HEALTH CARE COST; HEALTH CARE PLANNING; HEMATOMA; HOSPITAL CHARGE; HUMAN; IMMUNOSUPPRESSIVE TREATMENT; INCIDENCE; INTENSIVE CARE; LENGTH OF STAY; LUNG INSUFFICIENCY; MAJOR CLINICAL STUDY; MALE; MEDICAL HISTORY; MIDDLE AGED; MORBIDITY; MORTALITY RATE; OUTCOME ASSESSMENT; PATIENT CARE; PATIENT HISTORY OF RADIOTHERAPY; PATIENT TRANSPORT; POSTOPERATIVE CARE; POSTOPERATIVE COMPLICATION; POSTOPERATIVE DELIRIUM; POSTOPERATIVE INFECTION; POSTOPERATIVE PERIOD; PRIORITY JOURNAL; REOPERATION; RETROSPECTIVE STUDY; SEPSIS; WOUND COMPLICATION; CLINICAL TRIAL; FOLLOW UP; HEAD AND NECK NEOPLASMS; INTENSIVE CARE UNIT; MULTICENTER STUDY; ORGANIZATION AND MANAGEMENT; PLASTIC SURGERY; PROCEDURES; TRENDS;

ADULT; FEMALE; FOLLOW-UP STUDIES; FREE TISSUE FLAPS; HEAD AND NECK NEOPLASMS; HUMANS; INTENSIVE CARE UNITS; LENGTH OF STAY; MALE; MIDDLE AGED; POSTOPERATIVE CARE; RECONSTRUCTIVE SURGICAL PROCEDURES; RETROSPECTIVE STUDIES;

EID: 84955176241     PISSN: 0023852X     EISSN: 15314995     Source Type: Journal    
DOI: 10.1002/lary.25608     Document Type: Conference Paper

References (21)

1. Spiegel JH, Polat JK,. Microvascular flap reconstruction by otolaryngologists: prevalence, postoperative care, and monitoring techniques. Laryngoscope 2007; 117: 485-490.
2. Marsh M, Elliott S, Anand R, Brennan PA,. Early postoperative care for free flap head & neck reconstructive surgery-a national survey of practice. Br J Oral Maxillofac Surg 2009; 47: 182-185.
3. Haddock NT, Gobble RM, Levine JP,. More consistent postoperative care and monitoring can reduce costs following microvascular free flap reconstruction. J Reconstr Microsurg 2010; 26: 435-439.
4. Cornejo A, Ivatury S, Crane CN, Myers JG, Wang HT,. Analysis of free flap complications and utilization of intensive care unit monitoring. J Reconstr Microsurg 2013; 29: 473-480.
5. Chang CC, Kao HK, Huang JJ, Tsao CK, Cheng MH, Wei FC,. Postoperative alcohol withdrawal syndrome and neuropsychological disorder in patients after head and neck cancer ablation followed by microsurgical free tissue transfer. J Reconstr Microsurg 2013; 29: 131-136.
6. Nkenke E, Vairaktaris E, Stelzle F, Neukam FW, St Pierre M,. No reduction in complication rate by stay in the intensive care unit for patients undergoing surgery for head and neck cancer and microvascular reconstruction. Head Neck 2009; 31: 1461-1469.
7. Godden DR, Patel M, Baldwin A, Woodwards RT,. Need for intensive care after operations for head and neck cancer surgery. Br J Oral Maxillofac Surg 1999; 37: 502-505.
8. Mathew SA, Senthilnathan P, Narayanan V,. Management of post-operative maxillofacial oncology patients without the routine use of an intensive care unit. J Maxillofac Oral Surg 2010; 9: 329-333.
9. Bhama PK, Davis GE, Bhrany AD, Lam DJ, Futran ND,. The effects of intensive care unit staffing on patient outcomes following microvascular free flap reconstruction of the head and neck: a pilot study. JAMA Otolaryngol Head Neck Surg 2013; 139: 37-42.
10. Giannini A, Consonni D,. Physicians' perceptions and attitudes regarding inappropriate admissions and resource allocation in the intensive care setting. Br J Anaesth 2006; 96: 57-62.
11. Chalian AA, Anderson TD, Weinstein GS, Weber RS,. Internal jugular vein versus external jugular vein anastamosis: implications for successful free tissue transfer. Head Neck 2001; 23: 475-478.
12. Disa JJ, Polvora VP, Pusic AL, Singh B, Cordeiro PG,. Dextran-related complications in head and neck microsurgery: do the benefits outweigh the risks? A prospective randomized analysis. Plast Reconstr Surg 2003; 112: 1534-1539.
13. Suh JD, Sercarz JA, Abemayor E, et al., Analysis of outcome and complications in 400 cases of microvascular head and neck reconstruction. Arch Otolaryngol Head Neck Surg 2004; 130: 962-966.
14. McVeigh KP, Moore R, James G, Hall T, Barnard N,. Advantages of not using the intensive care unit after operations for oropharyngeal cancer: an audit at Worcester Royal Hospital. Br J Oral Maxillofac Surg 2007; 45: 648-651.
15. Klug C, Berzaczy D, Voracek M, et al., Experience with microvascular free flaps in preoperatively irradiated tissue of the oral cavity and oropharynx in 303 patients. Oral Oncol 2005; 41: 738-746.
16. Allak A, Nguyen TN, Shonka DC Jr, Reibel JF, Levine PA, Jameson MJ,. Immediate postoperative extubation in patients undergoing free tissue transfer. Laryngoscope 2011; 121: 763-768.
17. Pun BT, Ely EW,. The importance of diagnosing and managing ICU delirium. Chest 2007; 132: 624-636.
18. Davydow DS, Gifford JM, Desai SV, Needham DM, Bienvenu OJ,. Posttraumatic stress disorder in general intensive care unit survivors: a systematic review. Gen Hosp Psychiatry 2008; 30: 421-434.
19. Ferrari S, Copelli C, Bianchi B, et al., Free flaps in elderly patients: outcomes and complications in head and neck reconstruction after oncological resection. J Craniomaxillofac Surg 2013; 41: 167-171.
20. Arshad H, Ozer HG, Thatcher A, et al., Intensive care unit versus non-intensive care unit postoperative management of head and neck free flaps: comparative effectiveness and cost comparisons. Head Neck 2014; 36: 536-539.
21. Jones NF, Jarrahy R, Song JI, Kaufman MR, Markowitz B,. Postoperative medical complications-not microsurgical complications-negatively influence the morbidity, mortality, and true costs after microsurgical reconstruction for head and neck cancer. Plast Reconstr Surg 2007; 119: 2053-2060.