title: Early postoperative care for free flap head & neck reconstructive surgery--a national survey of practice.
abstract: There is considerable variation in the post-operative management of head and neck free flaps in the UK. We undertook a national postal survey of maxillofacial surgical units in the UK who perform free flap reconstruction following ablative head and neck surgery. Questions were asked about the routine postoperative care of a hypothetical, straightforward patient undergoing free flap reconstruction to determine whether there were any trends in managing these patients. There was considerable variation in the number of free flaps performed by each unit per year. The majority of patients (87%) are managed in either an intensive care or high dependency unit. The routine use of a tracheostomy is common (69%). There was also variation in the management of these cases, particularly with the requirement for ventilation. Few units routinely use dextran or dobutamine infusions, although one-to-one nursing and invasive cardiovascular monitoring are commonplace. Alternative provision of postoperative care is discussed.
authors.affiliation: Department of Anaesthetics, Queen Alexandra Hospital, Portsmouth, United Kingdom.
authors.forename: M
authors.initials: M
authors.lastname: Marsh
authors.forename: S
authors.initials: S
authors.lastname: Elliott
authors.forename: R
authors.initials: R
authors.lastname: Anand
authors.forename: P A
authors.initials: PA
authors.lastname: Brennan
mesh_terms: D006258:Head and Neck Neoplasms / Q000451:nursing / Q000601:surgery*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008991:Monitoring, Physiologic; D013527:Perioperative Nursing / Q000379:methods; D011182:Postoperative Care / Q000379:methods / Q000451:nursing / Q000592:standards*; D019651:Plastic Surgery Procedures / Q000379:methods / Q000592:standards*; D013524:Surgical Flaps; D011795:Surveys and Questionnaires; D014139:Tracheostomy / Q000706:statistics & numerical data; D006113:United Kingdom