A Standardized Operative Team for Major Head and Neck Cancer Ablation and Reconstruction

Abstract

Therapeutic, III.

Clinical pathway for abbreviated postoperative hospital stay in free tissue transfer to the head and neck: Impact in resource utilization and surgical outcomes

“…Despite a statistically significant decrease in operative and ischemia time among groups, we did not find a statistically significant difference in surgical complications, flap viability, flap outcomes, or need for reoperation among the groups, which speaks to the uniformity in the surgical aspects of care among the study population and supports the notion that the observed differences are a reflection of the changes in perioperative management. Longer operative and ischemia times have been related to increased LOS and complications . A recent prospective analysis on major head and neck surgeries (not restricted to free flap patients) suggested that operative time >220 minutes was associated with prolonged LOS .…”

“…Longer operative and ischemia times have been related to increased LOS and complications. [28][29][30] A recent prospective analysis on major head and neck surgeries (not restricted to free flap patients) suggested that operative time >220 minutes was associated with prolonged LOS. 30 Ischemia time >5 hours has been correlated to higher complication rates and partial flap loss.…”

“…31 Patients undergoing free flap reconstruction tend to have more advanced disease, advanced age, comorbidities, and anticipated longer operative time than for other major head and neck surgeries. 28,32 Nonetheless, standardization of the operative team for head and neck surgeries and accumulated institutional experience have been associated with reduced operative times, complication rates, and overall increased success. 28,32,33 We believe that the significant reduction in operative time and ischemia time observed with pathway implementation reflects the maturity and experience gained by the surgical team over time, and given our uniform surgical outcomes among the groups, its difficult to gauge the relative impact of prolonged operative and ischemia time on our collective results.…”

Reconstrucción de cabeza y cuello mediante colgajos libres microvascularizados. Indicaciones, aspectos técnicos y resultados

“…Es importante tener en cuenta la curva de aprendizaje de esta técnica para conseguir resultados fiables. Aunque no hay cifras exactas, la experiencia adquirida a partir de la realización de 30-50 CLM permite obtener resultados óptimos 11 . En nuestra serie, el número de intervenciones ha aumentado progresivamente con el paso de los años, hasta estabilizarse, permitiendo incorporar la técnica al arsenal terapéutico habitual y ampliar las indicaciones.…”

Free Flap Procedures for Reconstruction After Head and Neck Cancer

“…The entire operative team can affect the procedure duration. One study 9 sought to specifically evaluate the effect of the nursing team on procedure length by instituting a standardized OR nursing team for free flaps. The researchers compared the procedure lengths before and after the introduction of consistent nursing team members who were familiar with all aspects of the procedure.…”