Evaluation of Reconstructive Techniques of Oropharyngeal Defects

Stern, Jamie R.; Keller, Alex; Wenig, Barry L.

doi:10.1097/00000637-198811000-00021

Cited by 5 publications

(7 citation statements)

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“…Most authors report LOS of 16 to 20 days. 1,2,5–12 One report from a very experienced group at M.D. Anderson Hospital had a mean LOS of 11 days for patients who underwent rectus abdominis flap reconstruction of the head and neck, but this was with a small series of 30 free flaps.…”

Section: Discussionmentioning

confidence: 99%

“…For systematic analysis, defects were classified as oral cavity and mandible (41), glossectomy (12) , pharynx (including nasopharynx, oropharynx, hypopharynx or larynx, and cervical esophagus [14]), maxilla, face, or scalp (15) , skull base (7) , facial trauma (4) , osteoradionecrosis or fistula closure (3) , and vertebrectomy (1) . Complications were classified as surgical or medical and further divided into major or minor categories.…”

Section: Methodsmentioning

confidence: 99%

“…Despite the ascension of FTT in the reconstructive hierarchy, a considerable amount of debate rages regarding the costs and benefits of FTT. Several recent large series have shown decreased complication rates, 1–4 improved cosmesis, shorter hospital stay, 1–3,5 improved function, 1,6 and decreased resource utilization 5 with FTT when compared with pedicled flap reconstruction. Although several studies mention length of stay (LOS) as a component of resource utilization and costs, none has directly analyzed this factor in optimizing patient care.…”

Section: Introductionmentioning

confidence: 99%

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Length of Stay After Free Flap Reconstruction of the Head and Neck

Ryan

Hochman

2000

The Laryngoscope

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OfVectives: To analyze the incidence and timing of postoperative complications after free tissue transfer (FIT) and relate that to length of stay (LOS.) Study Design; We reviewed on surgeon's experience with 97 pa tients undergoing 100 head and neck reconstructions via FIT for a variety of traumatic and ablative defects. Methods: Charts were reviewed for d emographic data, type of d efect and flap, complications, LOS, length of intensive care unit (ICU) stay, date of decannulation, and first oral intake, any readmission to the hospital, and preoperative radiation status. llesults: Using strict guid lin s, 31 o of patien ts had some form of complication, including a 9o/o flap failure rate. Average postoperative LOS for all patients was 11 days. Average LOS for uncomplicated cases was 9 and for complicated cases was 16 days. For cases with flap-related complications th av rage LOS rose to 20 days. All reconstructive failures (d fined as patients requiring subsequent surgical procedures after a flap-related complication, regardless of outcome) occurred within the first 7 postoperative days. Three patients were readmitted for various rean s: a partial flap dehisc n ee (postoperative day [POD] 9), m eningitis (POD 24), and orocutaneous fistula (POD 22), for a 3.2% readmission rate. Fourteen percent of pa ti n ts were on a regimen of oral intake, and 13% had d cannulation by the time of discharge. Resumption of oral intalce and tracheostomy decannulation were accomplish d on a n outpatient b asis in the remainder of p atient • Conclusions: There were no preventable compUcations associated with early hospital discharge, nor was there evidence of adverse patient outcome. We conclude that early hospital disch arge is feasible after FIT reconstnaction and is consistent with quality care. Key Words: Free tissu transfer, head and n eck reconstruction, length of stay.Lary11goscope , 110:210-216, 2000 Present d at the Meeting of the Southern Section of the Am rican Laryngologicn l, Rhin ologico l a nd Otologica l Society, Inc., New Orleans, Loui siana, J a nu ary 15, 1.999.From the D partment of Otolaryngology a nd omm unicetive Scinces (M.W.R., M.11 .), Th M dical University of South arolina, and The Facial Surg ry enter (M .11. ), ha rleston, South a rolina; end the Departrn nt ofO tolaryngology (M.W.R.),

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Length of Stay After Free Flap Reconstruction of the Head and Neck

Ryan

Hochman

2000

The Laryngoscope

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“…1 Although length of stay (LOS), blood product administration, surgical site infections, readmissions, unplanned return to the operating room, and mortality data are limited, they are used to measure surgical performance. 2 Free flap reconstruction decreases complication rates, LOS, [3][4][5][6][7] and improves functional outcomes. 6 However, head and neck cancer patients often carry multiple medical and social comorbidities, increasing their risk for suboptimal outcomes.…”

Section: Introductionmentioning

confidence: 99%

Improving quality outcomes in head and neck free flap surgery with the use of a physician inpatient coordinator

et al. 2017

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“…In recent years the emphasis has turned to microvascular reconstruction with various free flaps that permit enhanced functional and cosmetic results, and a reduction in the number of surgical complications. This, however, requires a trained microsurgical team and expensive equipment, which are not always available in countries with economic problems (19,22).…”

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confidence: 99%

Clinical Evaluation of the Pectoralis Major Flap for Reconstruction in Head and Neck Cancer

Pikani¹,

Ulla²,

Tuulik³

1994

Scandinavian Journal of Plastic and Reconstructive Surgery and

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Sixty two patients (7 women and 55 men) with head and neck cancer underwent 64 musculocutaneous or osteomusculocutaneous reconstructions in the Department of Head and Neck Tumours, Estonian Cancer Centre, from May 1988 to December 1991. Two men had two reconstructions. The patients were evaluated for surgical, functional, aesthetic, and also for oncological results. The flap-related complication rate was higher among women than men (6/7 (86%) compared with 19/57 (33%), p = 0.012), and in the group of osteomusculocutaneous flaps which contained a segment of the fifth or sixth rib compared with the musculocutaneous ones (5/6 (83%) compared with 20/58 (34%), p = 0.03). The functional results were good or satisfactory in 41/60 (68%) of the cases. Mean follow-up time was 32 months; 31/58 (53%) of patients operated on due to primary or recurrent cancer are alive, with or without recurrent disease. We do not recommend the inclusion of rib segments in pedicled pectoral flaps for reconstructions of head and neck defects.

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Evaluation of Reconstructive Techniques of Oropharyngeal Defects

Cited by 5 publications

References 0 publications

Length of Stay After Free Flap Reconstruction of the Head and Neck

Length of Stay After Free Flap Reconstruction of the Head and Neck

Improving quality outcomes in head and neck free flap surgery with the use of a physician inpatient coordinator

Clinical Evaluation of the Pectoralis Major Flap for Reconstruction in Head and Neck Cancer

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