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Intensive care unit versus non–intensive care unit postoperative management of head and neck free flaps: Comparative effectiveness and cost comparisons
Author(s) -
Arshad Hassan,
Ozer Hatice Gulcin,
Thatcher Aaron,
Old Matthew,
Ozer Enver,
Agarwal Amit,
Jafari Hosseinali,
Birkheimer Danette,
Basinger Heidi,
Forest L. Arrick,
Schuller David E.,
Teknos Theodoros N.
Publication year - 2014
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.23325
Subject(s) - medicine , intensive care unit , head and neck , free flap , free flap reconstruction , surgery , head and neck cancer , specialty , retrospective cohort study , intensive care medicine , pathology , radiation therapy
Background Despite its widespread use, there is no consensus on the postoperative management in patients undergoing free flap reconstructions. We report the largest study comparing flap outcomes, morbidity, and cost in patients with head and neck cancer free flaps who recovered in the intensive care unit (ICU) versus a “specialty floor” setting. Methods This was a retrospective review of patients undergoing free flap surgery for head and neck defects over a 4‐year period. Patients before a certain date went to the ICU for immediate postoperative care and after to a non‐ICU setting. Postoperative medical and surgical complications and hospital charges were analyzed. Results Patients in the ICU group had a longer length of stay (LOS) and incurred greater hospital costs than the patients in the non‐ICU setting. There was no difference in the flap failure rate between the 2 groups. Conclusion Consideration should be given to a floor‐based postoperative management regimen for this patient population. © 2013 Wiley Periodicals, Inc. Head Neck 36 : 536–539, 2014