The team concept in mandibular reconstruction after ablative oncologic surgery.
OBJECTIVE
This study evaluated the efficiency and cost-effectiveness of using a reconstructive team for mandibular reconstruction.


METHODS
An outcome-based retrospective review of 64 patients who had undergone microvascular fibular reconstruction of the mandible was performed. Operating room time, use of blood products, intraoperative fluid replacement, and hospital and intensive care unit stay were evaluated. Patients were divided into 2 groups on a chronologic basis. Group 1 was the first 34 consecutive patients and group 2 was the next 30 consecutive patients.


RESULTS
Group 2 had a significantly shorter operating room time (P < .0001), hospital stay (P = .012), and used significantly less blood (P = .002) and colloid (P = .044) than group 1, resulting in significant cost savings, ($5,061.47/patient). Analysis showed no differences between groups demographically or for wound complications.


CONCLUSIONS
Experience and the development of a team concept significantly decreased the cost for mandibular reconstruction with free fibula flaps without increasing wound complications.
Lydiatt
D D
DD
Department of Otolaryngology, University of Nebraska Medical Center, Omaha 68198-1225, USA. DLydiatt@UNMC.edu
Hollins
R R
RR
Friedman
A
A
Lydiatt
C A
CA
D000776:Anesthesiology / Q000191:economics; D001803:Blood Transfusion / Q000191:economics; D003362:Cost-Benefit Analysis; D017050:Episode of Care; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008339:Mandibular Neoplasms / Q000534:rehabilitation / Q000601:surgery*; D008833:Microcirculation / Q000601:surgery; D008866:Microsurgery / Q000191:economics; D008875:Middle Aged; D009873:Operating Rooms / Q000191:economics; D019647:Oral Surgical Procedures / Q000191:economics*; D010348:Patient Care Team / Q000191:economics* / Q000706:statistics & numerical data*; D019651:Plastic Surgery Procedures / Q000191:economics*; D012189:Retrospective Studies; D013524:Surgical Flaps