Enhanced recovery programmes in head and neck surgery: systematic review

Bannister, Miles; Ah‐See, Kim

doi:10.1017/s0022215115000936

Cited by 17 publications

(23 citation statements)

References 39 publications

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“…The high sensitivity, fast time response, and biodegradability of our sensor means that it could also be of value in biomedical applications beyond orthopedic rehabilitation monitoring. For example, it could be relevant to cardiovascular patches 26 and reconstructive surgery 27 , where the monitoring of mechanical deformations and pressures real time in vivo will allow for refined and personalized medicine. Future research will consist of developing a wireless system made entirely of biodegradable materials, including the circuit used for wireless transmission of measured signals though the skin.…”

Section: Discussionmentioning

confidence: 99%

A stretchable and biodegradable strain and pressure sensor for orthopaedic application

et al. 2018

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The ability to monitor, in real time, the mechanical forces on tendons after surgical repair could allow personalised rehabilitation programs to be developed for recovering patients. However, the development of devices capable of such measurements has been hindered by the strict requirements of biocompatible materials and the need for sensors with satisfactory performance. Here we report an implantable pressure and strain sensor made entirely of biodegradable materials. The sensor is designed to degrade after its useful lifetime, eliminating the need for a second surgery to remove the device. It can measure strain and pressure independently using two vertically isolated sensors capable of discriminating strain as small as 0.4% and the pressure exerted by a grain of salt (12 Pa) without interfering with one another. The device has minimal hysteresis, a response time in the millisecond range, and an excellent cycling stability for strain and pressure sensing, respectively. We have incorporated a biodegradable elastomer which was optimized to improve the strain cycling performances by 54%. An in vivo study shows that the sensor exhibits excellent biocompatibility and function in a rat model, illustrating the potential applicability of the device to the real-time monitoring of tendon healing. Text body In the U.S. alone, around 14 million people per year suffer from tendon, ligament, and joint injuries 1. After injury, tissues in the body undergo changes in their native biomechanical properties in order to repairs themselves. This is true for both hard tissues (bones) and soft tissues (tendons, skin, muscles). The objective of surgery and rehabilitation is to restore the tissues to their pre-injury function, with biomechanical properties as close as possible to native properties 2. A diagnostic tool that measures the biomechanical properties of the repair site in real-time would represent a significant step towards improved assessment of healing and the development of personalized rehabilitation strategies 3. Current clinical practice for monitoring tissue rehabilitation includes magnetic resonance imaging (MRI) or ultrasound, which provide a snapshot of tissue density and inflammation 4. Implantable sensors could give continuous information about tissue strain during rehabilitation protocols, as well as during the patient's daily activities, allowing activities to be tailored based on what the tissue can tolerate. Previously described implantable sensors have limited biocompatibility or have been designed for laboratory biomechanics studies rather than clinical practice 4,5 .

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Section: Discussionmentioning

confidence: 99%

A stretchable and biodegradable strain and pressure sensor for orthopaedic application

et al. 2018

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“…25 To date, ERAS has been implemented in various surgical specialties. 4,5,7,22,30,38,41,45,49,57 As the earliest discipline to implement ERAS, colorectal surgery offers a substantial body of literature supporting its benefits. 10 For example, a meta-analysis of 16 randomized controlled trials (RCTs) of patients undergoing colorectal surgery found a significant reduction of overall morbidity and LOS with use of an ERAS protocol.…”

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confidence: 99%

Enhanced recovery after spine surgery: a systematic review

Elsarrag¹,

Soldozy²,

Patel³

et al. 2019

Neurosurgical Focus

168

113

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OBJECTIVEEnhanced recovery after surgery (ERAS) is a multidimensional approach to improving the care of surgical patients using subspecialty- and procedure-specific evidence-based protocols. The literature provides evidence of the benefits of ERAS implementation, which include expedited functional recovery, decreased postoperative morbidity, reduced costs, and improved subjective patient experience. Although extensively examined in other surgical areas, ERAS principles have been applied to spine surgery only in recent years. The authors examine studies investigating the application of ERAS programs to patients undergoing spine surgery.METHODSThe authors conducted a systematic review of the PubMed and MEDLINE databases up to November 20, 2018.RESULTSTwenty full-text articles were included in the qualitative analysis. The majority of studies were retrospective reviews of nonrandomized data sets or qualitative investigations lacking formal control groups; there was 1 protocol for a future randomized controlled trial. Most studies demonstrated reduced lengths of stay and no increase in rates of readmissions or complications after introduction of an ERAS pathway.CONCLUSIONSThese introductory studies demonstrate the potential of ERAS protocols, when applied to spine procedures, to reduce lengths of stay, accelerate return of function, minimize postoperative pain, and save costs.

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“…3,4 In addition, the last 2 decades have seen greater emphasis on safety, quality, and perioperative management in an effort to optimize patient outcomes. 5…”

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confidence: 99%

Long‐term Trends in Head and Neck Surgery Outcomes

Mowery

Light

Clayburgh

2018

Otolaryngol.--head neck surg.

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Substantial improvement in postoperative morbidity and mortality has taken place in head and neck surgery over the past decades. Static complication rates in some procedures may reflect that the improvement of surgical techniques allow for the treatment of sicker patients. The trends seen in this study speak to the importance of probing further why high rates of complications are still seen in certain procedures and ensuring that effective treatment is balanced with limiting morbidity and mortality.

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Enhanced recovery programmes in head and neck surgery: systematic review

Abstract: Considerable evidence is available supporting enhanced recovery in head and neck surgery that could be of benefit to patients and which surgeons should be aware of.

Cited by 17 publications

References 39 publications

A stretchable and biodegradable strain and pressure sensor for orthopaedic application

A stretchable and biodegradable strain and pressure sensor for orthopaedic application

Enhanced recovery after spine surgery: a systematic review

Long‐term Trends in Head and Neck Surgery Outcomes

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