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Enhanced Recovery After Surgery-Based Perioperative Protocol for Head and Neck Free Flap Reconstruction.
- Source :
-
OTO open [OTO Open] 2020 Jun 02; Vol. 4 (2), pp. 2473974X20931037. Date of Electronic Publication: 2020 Jun 02 (Print Publication: 2020). - Publication Year :
- 2020
-
Abstract
- Objectives: Evaluate an enhanced recovery after surgery (ERAS)-based free flap management protocol implemented at our center.<br />Study Design: Prospective cohort study of patients after implementation of an ERAS-based perioperative care protocol for patients undergoing free flap reconstruction of the head and neck as compared with a historical control group.<br />Setting: Tertiary care academic medical center.<br />Participants and Methods: All patients undergoing free flap reconstruction were prospectively enrolled in the ERAS protocol group. A retrospective control group was identified by randomly selecting an equivalent number of patients from a records search of those undergoing free flap surgery between 2009 and 2015. Blood transfusion, complications, 30-day readmission rates, intensive care unit (ICU) and hospital length of stay, and costs of hospitalization were compared.<br />Results: Sixty-one patients were included in each group. Patients in the ERAS group underwent less frequent flap monitoring by physicians and had lower rates of intraoperative (70.5% vs 86.8%, P = .04) and postoperative (49.2% vs 27.2%, P = .026) blood transfusion, were more likely to be off vasopressors (98.3% vs 50.8%, P < .01) and ventilator support (63.9% vs 9.8%, P < .01) at the conclusion of surgery, and had shorter ICU stays (2.11 vs 3.39 days, P = .017). Length of stay, readmissions, and complication rates did not significantly differ between groups.<br />Conclusion: ERAS-based perioperative practices for head and neck free flap reconstruction can reduce time on the ventilator and in the ICU and the need for vasopressors, blood transfusions, and labor-intensive flap monitoring, without adverse effects on outcomes.<br /> (© The Authors 2020.)
Details
- Language :
- English
- ISSN :
- 2473-974X
- Volume :
- 4
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- OTO open
- Publication Type :
- Academic Journal
- Accession number :
- 32537554
- Full Text :
- https://doi.org/10.1177/2473974X20931037