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

The Laryngoscope
Aru PanwarWilliam Lydiatt

Abstract

To study the impact of a non-intensive care unit (ICU)-based postoperative management strategy on patient outcomes following vascularized free tissue transfer for head and neck surgical defects. Retrospective cohort study. The patients consisted of two groups of adults who underwent vascularized free tissue transfer for head and neck reconstruction between July 2007 and June 2012, at an academic and a community-based hospital. By protocol, the first group of patients had a planned admission to the intensive care unit. After creation of a designated head and neck surgical unit, the second group was cared for in a protocol driven, non-ICU setting. Outcomes and costs were compared between the two patient groups. There was no adverse impact on flap survival, inpatient morbidity, or mortality with the implementation of postoperative care outside of an ICU. The patients who stayed in the ICU in the immediate postoperative period had a longer median length of hospital stay (ICU vs. non-ICU, 8 days [interquartile range {IQR} = 7-11 days] vs. 7 days [IQR = 6-9.5 days], P = .001). Median hospital charges and cost of care for patients who received ICU-based care (US$109,367 [IQR = US$88,112-US$130,833] and US$33,642 [IQR = US$28,143-US$43...Continue Reading

References

Feb 25, 2000·The British Journal of Oral & Maxillofacial Surgery·D R GoddenR T Woodwards
Aug 18, 2004·Archives of Otolaryngology--head & Neck Surgery·Jeffrey D SuhKeith E Blackwell
Jun 26, 2007·The British Journal of Oral & Maxillofacial Surgery·K P McVeighN Barnard
Aug 19, 2007·Chest·Brenda T Pun, E Wesley Ely
Jul 22, 2008·The British Journal of Oral & Maxillofacial Surgery·M MarshP A Brennan
Sep 9, 2008·General Hospital Psychiatry·Dimitry S DavydowO Joseph Bienvenu
May 14, 2010·Journal of Reconstructive Microsurgery·Nicholas T HaddockJamie P Levine
Mar 25, 2011·The Laryngoscope·Amir AllakMark J Jameson
Dec 23, 2011·Journal of Maxillofacial and Oral Surgery·Seema Alice MathewVinod Narayanan
Aug 14, 2012·Journal of Cranio-maxillo-facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery·S FerrariE Sesenna
May 11, 2013·Journal of Reconstructive Microsurgery·Agustin CornejoHoward T Wang

❮ Previous
Next ❯

Citations

Jun 15, 2016·Head & Neck·Eeva HaapioTuomas Kiviniemi
Aug 1, 2018·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Elliot MorseSaral Mehra
Sep 9, 2018·The Laryngoscope·Kevin J KovatchChaz L Stucken
Aug 16, 2019·Current Opinion in Otolaryngology & Head and Neck Surgery·Harrison CashJeffrey J Houlton
Mar 5, 2019·Laryngoscope Investigative Otolaryngology·Phoebe K YuDaniel G Deschler
Jun 13, 2017·Current Opinion in Otolaryngology & Head and Neck Surgery·Michael R Kinzinger, Arnaud F Bewley
Jun 28, 2018·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Sheng-Chiao LinYu-Hsuan Lin
Dec 7, 2020·The Laryngoscope·Matthew StewartJoseph M Curry
Jan 8, 2021·Facial Plastic Surgery & Aesthetic Medicine·Beatrice C GoKarthik Rajasekaran
Jun 27, 2021·American Journal of Otolaryngology·Sean M MooneyRichard M Rosenfeld

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.